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Idaho 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
$44.67 / $57.14 / $85.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.57 / $82.61 / $118.01
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.06 / $69.04 / $90.57
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.45 / $95.10 / $123.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.21 / $101.87 / $132.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.25 / $200.43 / $270.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.03 / $84.83 / $105.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.70 / $84.18 / $115.29