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New Mexico 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
$39.51 / $39.51 / $49.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $51.50 / $68.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.99 / $54.98 / $89.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.32 / $72.29 / $109.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.51 / $50.65 / $70.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.55 / $70.25 / $109.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.69 / $95.16 / $128.78