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Iowa 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
Facility
Modifier
Low / Median / High Price
$56.18 / $56.18 / $66.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.06 / $51.49 / $59.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $110.73 / $140.07
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.78 / $63.48 / $150.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.86 / $68.84 / $122.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.81 / $97.99 / $322.24
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.84 / $97.99 / $122.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $101.00 / $129.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.93 / $73.67 / $136.81
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.20 / $71.90 / $86.10