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Nebraska 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
$47.83 / $47.83 / $54.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.64 / $49.35 / $57.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.08 / $129.44 / $262.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.02 / $84.09 / $115.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.54 / $112.44 / $141.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.22 / $56.83 / $101.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.25 / $114.15 / $322.24
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.70 / $101.00 / $129.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $101.00 / $129.44
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.50 / $94.48 / $124.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.42 / $114.15 / $143.60