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West 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.

Facilitymedian $78 · 10th–90th $71–$790%50%10th90th$78Professionalmedian $72 · 10th–90th $58–$830%20%10th90th$72$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $72.44 / $83.18
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $95.50
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $97.72 / $389.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $91.20 / $138.04