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Alaska rates for HCPCS 99426

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; first 30 minutes of clinical staff time directed by physician or other qualified health care professional, per calendar month.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.13 / $136.13 / $163.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $56.57 / $99.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.91 / $164.28 / $215.76
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.60 / $63.70 / $139.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.86 / $160.00 / $200.79
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.20 / $124.44 / $189.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.55 / $70.37 / $139.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.43 / $131.18 / $219.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.52 / $172.60 / $217.22