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Alaska rates for HCPCS 99425

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; each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Facilitymedian $54 · 10th–90th $43–$1070%10%20%10th90th$54Professionalmedian $52 · 10th–90th $43–$1320%10%20%10th90th$52$50.0$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
$144.54 / $144.54 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $51.29 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $141.25 / $208.93
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $53.70 / $107.15
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $131.83 / $199.53
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $144.54 / $169.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $53.70 / $102.33
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $79.43 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $147.91 / $208.93