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Extra Monthly Time Managing One Complex Condition

Illinois rates for HCPCS 99425

Covers further time a doctor or other qualified professional spends during a month managing a single serious, complex ongoing health problem: reviewing results, adjusting treatment, and coordinating with everyone else involved in that person's care. It is billed in addition to the main monthly management service.

Facilitymedian $68 · 10th–90th $46$1230%10%10th90th$68Professionalmedian $52 · 10th–90th $42$760%10%20%10th90th$52$50.0$100.0$200.0$500.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$64.57
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$51.29
Typical High
$67.61
BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$524.81
Typical High
$1,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$64.57
Typical High
$74.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$75.86
Typical High
$104.71
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$70.79
Typical High
$186.21
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$63.10
Typical High
$79.43
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$91.20
United
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$70.79
Typical High
$104.71