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Nebraska 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
$46.06 / $46.06 / $57.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.29 / $53.51 / $71.56
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.69 / $141.69 / $141.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.08 / $129.44 / $262.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.97 / $83.48 / $116.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.77 / $117.97 / $145.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.10 / $58.82 / $108.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.79 / $119.91 / $309.19
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.92 / $100.78 / $124.49
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.92 / $97.14 / $124.49
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.77 / $92.00 / $130.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.02 / $125.23 / $150.83