go back

Mississippi 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
$41.69 / $51.29 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $51.29 / $64.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $63.10 / $66.07
Ambetter
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$66.07 / $66.07 / $66.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $104.71 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $66.07 / $87.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $181.97 / $263.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $60.26 / $83.18