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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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $64.57 / $69.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $51.29 / $64.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $64.57 / $69.18
Ambetter
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$66.07 / $66.07 / $66.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $72.44 / $97.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $77.62 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $66.07 / $89.13
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $75.86 / $83.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $158.49 / $302.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $63.10 / $83.18