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Utah 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
$75.86 / $75.86 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $70.79 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $102.33 / $138.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $165.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $95.50 / $123.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $87.10 / $102.33
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $91.20 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $89.13 / $125.89