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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
$47.86 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $50.12 / $64.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $218.78 / $660.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $112.20 / $177.83
BCBS
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$56.23 / $87.10 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $229.09 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $162.18 / $275.42
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $218.78 / $426.58
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $162.18 / $229.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $67.61 / $128.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $138.04 / $309.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $263.03 / $354.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $114.82 / $194.98