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Wisconsin 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
$70.79 / $138.04 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $70.79 / $93.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $104.71 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $257.04 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $186.21 / $239.88
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $77.62 / $102.33
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $154.88 / $223.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $77.62 / $109.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $169.82 / $512.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $134.90 / $229.09
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $467.74
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $199.53 / $512.86
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $138.04 / $169.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $128.82 / $223.87