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Ohio 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
$58.13 / $64.76 / $217.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.13 / $67.83 / $84.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.65 / $77.98 / $116.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.77 / $65.95 / $94.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.48 / $87.25 / $136.07
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.48 / $87.95 / $132.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.98 / $71.16 / $101.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.56 / $101.54 / $148.27