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Arkansas 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.

Facilitymedian $72 · 10th–90th $52–$1020%20%40%10th90th$72Professionalmedian $51 · 10th–90th $40–$690%10%20%10th90th$51$10.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $64.57 / $69.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $67.61
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $69.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $97.72
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $77.62 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $66.07 / $87.10
Qualchoice
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $181.97 / $288.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $63.10 / $85.11