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Kansas 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
$49.41 / $55.88 / $69.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.59 / $49.41 / $62.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $1.01 / $1.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.10 / $0.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.86 / $74.36 / $95.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.86 / $51.27 / $65.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.04 / $82.18 / $389.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.74 / $76.95 / $106.55