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Oregon 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
$90.05 / $163.38 / $183.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.37 / $77.04 / $115.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.10 / $171.18 / $221.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.57 / $154.63 / $195.53
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.20 / $90.05 / $183.43
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.57 / $144.26 / $236.59
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.26 / $148.07 / $166.16
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.08 / $90.05 / $183.43
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.14 / $138.88 / $204.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.81 / $133.38 / $203.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.68 / $161.47 / $252.96