go back

New Jersey rates for HCPCS 99424

Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $70.79 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $72.44 / $100.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $79.43 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $104.71 / $158.49
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $91.20 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $83.18 / $144.54