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Tennessee 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
$39.64 / $45.07 / $97.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.06 / $49.35 / $58.59
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.07 / $55.07 / $55.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.06 / $53.64 / $96.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.70 / $73.73 / $109.55
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.12 / $250.85 / $250.85
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.24 / $369.98 / $369.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.61 / $64.88 / $115.50