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Illinois 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
$32.47 / $44.51 / $75.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.46 / $37.86 / $52.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.65 / $357.30 / $692.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.77 / $53.54 / $62.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.97 / $54.24 / $81.96
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.32 / $55.95 / $120.00
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.89 / $44.07 / $68.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $50.46 / $77.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.62 / $61.27 / $92.99