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Alaska rates for HCPCS 99427

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; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Facilitymedian $40 · 10th–90th $29–$780%10%10th90th$40Professionalmedian $40 · 10th–90th $29–$930%10%10th90th$40$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $97.72 / $162.18
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $38.90 / $74.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $91.20 / $173.78
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $97.72 / $134.90
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $39.81 / $72.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $61.66 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $100.00 / $151.36