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Indiana 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
$30.08 / $40.47 / $53.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.67 / $37.11 / $48.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.63 / $71.63 / $71.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.34 / $9.34 / $32.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.34 / $22.15 / $36.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.09 / $32.02 / $36.95
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.80 / $46.56 / $55.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.77 / $47.97 / $68.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.70 / $50.62 / $69.80