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Care Management Services by Clinical Staff (Monthly)

Maryland rates for HCPCS 99426

Ongoing coordination and monitoring of care for a patient with one serious chronic condition, provided by clinical staff working under a doctor's or other provider's direction, for at least the first thirty minutes in a calendar month. This can include tasks like medication management, care planning, and communication between the patient's different providers, done outside of an in-person office visit. It supports patients whose single complex condition puts them at meaningful risk of complications or worsening health.

Rates data updated July 2026.

How much does Care Management Services by Clinical Staff (Monthly) cost?

$48.98

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $48.98 for this service. Most negotiated rates run $45.71 to $60.26.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $58 · 10th to 90th $58 to $72Professionalmedian $49 · 10th to 90th $41 to $65
$50$100facility $58professional $49

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$72.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$48.98
Typical High
$61.66
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$51.29
Typical High
$72.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$69.18
Typical High
$114.82
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$56.23
Typical High
$81.28
United
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$67.61
Typical High
$112.20
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$93.33
Typical High
$109.65

Where Maryland sits

The same service costs 2.0 times more in Minnesota than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maryland· 49th of 51

$48.98

MN $100KS $48.98

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.