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New Mexico 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
$41.12 / $41.12 / $47.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.12 / $48.93 / $62.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.48 / $56.18 / $99.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.51 / $74.43 / $104.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $92.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.12 / $49.33 / $67.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.46 / $71.40 / $104.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.08 / $88.75 / $122.46