go back

Florida 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
$40.51 / $50.36 / $96.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $50.10 / $63.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.04 / $61.04 / $67.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.75 / $66.23 / $102.78
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.73 / $44.25 / $56.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.70 / $79.15 / $133.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.30 / $65.92 / $107.40
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.58 / $52.73 / $52.73