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Iowa 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.25 / $39.25 / $56.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.67 / $37.09 / $48.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.90 / $94.91 / $118.64
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.58 / $52.53 / $100.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.65 / $51.18 / $96.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.71 / $72.43 / $218.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.01 / $70.64 / $93.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.01 / $70.64 / $96.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.79 / $61.45 / $109.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.60 / $50.20 / $73.80