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Kentucky 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
$40.88 / $51.13 / $76.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.97 / $47.75 / $59.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $40.10 / $51.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.09 / $54.13 / $67.22
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.09 / $58.96 / $77.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.92 / $67.92 / $67.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.06 / $60.96 / $117.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $58.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.24 / $65.94 / $97.46