go back

Minnesota 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
$48.50 / $61.10 / $61.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.32 / $52.18 / $66.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.55 / $181.71 / $349.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.17 / $109.29 / $166.19
BCBS
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$57.95 / $89.81 / $134.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.21 / $217.39 / $522.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.37 / $164.79 / $266.83
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.70 / $198.74 / $411.78
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.18 / $152.30 / $222.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.55 / $73.33 / $128.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.84 / $137.80 / $309.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.84 / $122.17 / $212.91