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Hawaii 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.

Professionalmedian $50 · 10th–90th $40–$650%10%20%10th90th$50$50.0$100.0

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
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $66.07 / $134.90
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $64.57 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $72.44 / $91.20
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $75.86 / $77.62