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Texas 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
$60.26 / $67.61 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $72.44 / $91.20
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $85.11 / $107.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $75.86 / $85.11
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $70.79 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $89.13 / $141.25
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $75.86 / $107.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $72.44 / $104.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $72.44 / $97.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $89.13 / $138.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $87.10 / $125.89
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $85.11 / $107.15