go back

Additional Care Management Time By Staff

Illinois rates for HCPCS 99427

This service covers extra time each month, beyond an initial block already billed separately, that a doctor's clinical staff spends coordinating care for a patient managing a single ongoing health condition that puts them at significant risk of complications. The work is done under the supervision of the treating doctor and includes things like medication oversight, care planning, and communicating with other members of the care team. It does not involve a face-to-face visit.

Rates data updated October 2026.

How much does Additional Care Management Time By Staff cost?

$42.66

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $42.66 for this service. The price depends on where it is billed: about $42.66 from a physician practice, and about $295 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$42.66$32.36 to $45.71
FacilityA hospital or hospital-owned outpatient department$295$43.65 to $427

How much rates vary

Facilitymedian $295 · 10th to 90th $32 to $646Professionalmedian $43 · 10th to 90th $32 to $63
$50$100$200$500facility $295professional $43

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$28.18
Median
$38.02
Typical High
$77.62
Aetna
Setting
Professional
Modifier
None
Typical Low
$28.84
Median
$35.48
Typical High
$43.65
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$14.45
Median
$17.38
Typical High
$21.88
Ambetter
Setting
Professional
Modifier
None
Typical Low
$56.23
Median
$56.23
Typical High
$58.88
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$169.82
Median
$363.08
Typical High
$724.44
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$36.31
Median
$53.70
Typical High
$63.10
Cigna
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$52.48
Typical High
$83.18
Hally Health
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$46.77
Typical High
$81.28
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$43.65
Typical High
$67.61
Molina
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
United
Setting
Professional
Modifier
None
Typical Low
$33.88
Median
$51.29
Typical High
$81.28

Where Illinois sits

The same service costs 4.1 times more in Alaska than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 28th of 51

$42.66

AK $91.20IN $22.39

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.