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Virginia 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
$73.48 / $79.65 / $81.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.09 / $73.48 / $82.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.11 / $80.97 / $106.09
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.95 / $76.95 / $107.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.60 / $99.60 / $99.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.23 / $93.64 / $144.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.48 / $80.97 / $107.06
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.46 / $76.37 / $109.60
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.00 / $138.37 / $160.88
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.23 / $92.22 / $317.89
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.44 / $101.31 / $351.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.31 / $103.24 / $174.69