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New Hampshire 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
$60.26 / $60.26 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $51.29 / $69.18
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $81.28 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $89.13 / $158.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $77.62 / $138.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $91.20 / $154.88
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71