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Delaware 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
Professional
Modifier
Low / Median / High Price
$39.92 / $49.14 / $60.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.15 / $69.62 / $93.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.52 / $66.90 / $180.90