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Arizona 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)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.85 / $50.12 / $60.46
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.07 / $55.07 / $55.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.25 / $42.00 / $73.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.24 / $42.54 / $54.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.95 / $61.42 / $98.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.47 / $49.35 / $93.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.94 / $77.70 / $369.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.94 / $62.64 / $115.16