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Extra Monthly Time Managing One Complex Condition

Wisconsin 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.

Rates data updated July 2026.

Facilitymedian $56 · 10th–90th $47$1320%20%10th90th$56Professionalmedian $60 · 10th–90th $45$1380%10%10th90th$60$20.0$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
Facility
Modifier
Global
Typical Low
$48.98
Median
$56.23
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$51.29
Typical High
$66.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$75.86
Typical High
$144.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$190.55
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$128.82
Typical High
$173.78
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$56.23
Typical High
$79.43
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$109.65
Typical High
$162.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$56.23
Typical High
$85.11
Medica
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$123.03
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Network Health
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$61.66
Typical High
$134.90
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$56.23
Typical High
$79.43
Quartz
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$158.49
Quartz
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$323.59
Quartz
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$147.91
Typical High
$371.54
Security Health
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$69.18
Security Health
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$104.71
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$91.20
Typical High
$158.49