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New York 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
$74.13 / $102.33 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $72.44 / $112.20
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $89.13 / $91.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $77.62 / $141.25
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $104.71 / $104.71
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $104.71 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $107.15 / $218.78
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $75.86 / $181.97
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $141.25 / $194.98
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $77.62 / $77.62
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $91.20 / $151.36
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $117.49 / $131.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $89.13 / $181.97
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $70.79 / $95.50
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $91.20 / $154.88