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Vermont 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
Professional
Modifier
Low / Median / High Price
$48.83 / $57.30 / $66.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.22 / $62.67 / $102.20
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.22 / $73.40 / $117.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.49 / $89.17 / $171.42