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Vermont 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
Professional
Modifier
Low / Median / High Price
$67.68 / $81.94 / $92.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.06 / $85.48 / $147.03
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.06 / $105.50 / $162.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.01 / $123.87 / $239.07