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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
$34.67 / $72.44 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $38.90 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $97.72 / $120.23
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $50.12 / $151.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $50.12 / $162.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $72.44 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $70.79 / $112.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $70.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $54.95 / $97.72
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $51.29 / $74.13