go back

New Mexico 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.

Facilitymedian $79 · 10th–90th $60–$1350%10%10th90th$79Professionalmedian $71 · 10th–90th $59–$910%10%20%10th90th$71$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $107.15 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $70.79 / $89.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $77.62 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $104.71 / $151.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $72.44 / $91.20
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $102.33 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $117.49 / $165.96