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Extra Monthly Time Managing One Complex Condition

Maine 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.

Professionalmedian $52 · 10th–90th $44$890%20%10th90th$52$50.0$100.0$200.0

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
Professional
Modifier
Global
Typical Low
$43.65
Median
$51.29
Typical High
$66.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$67.61
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$72.44
Typical High
$100.00
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$64.57
Typical High
$114.82
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$51.29
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$75.86
Typical High
$104.71