go back

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
$65.68 / $96.42 / $149.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.86 / $73.08 / $112.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.41 / $75.15 / $127.37
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.46 / $105.46 / $105.46
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.46 / $105.46 / $116.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.60 / $99.60 / $99.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.53 / $99.41 / $205.76
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.88 / $92.00 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.47 / $131.53 / $198.16
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.76 / $78.29 / $78.29
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.01 / $90.03 / $145.08
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.60 / $99.60 / $74,999.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.04 / $105.97 / $210.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.09 / $92.74 / $188.36
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.48 / $78.29 / $104.53
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.29 / $93.21 / $181.71