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Nevada 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
$38.24 / $39.27 / $49.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.92 / $49.46 / $63.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.86 / $51.50 / $70.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.86 / $60.48 / $96.60
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.34 / $67.45 / $87.69
Hometown Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.23 / $102.23 / $102.23
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.71 / $47.25 / $65.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.07 / $71.92 / $124.43