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Indiana 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
$43.94 / $50.12 / $63.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.30 / $48.83 / $57.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.23 / $15.23 / $47.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.23 / $22.84 / $45.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.78 / $45.83 / $52.89
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.10 / $54.56 / $65.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.90 / $63.33 / $85.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.02 / $63.52 / $87.30