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Minnesota 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)

Facilitymedian $98 · 10th–90th $39–$3720%10%10th90th$98Professionalmedian $63 · 10th–90th $33–$1380%5%10th90th$63$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $46.77 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $37.15 / $48.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $64.57 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $85.11 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $177.83 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $131.83 / $223.87
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $186.21 / $371.54
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $131.83 / $181.97
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $52.48 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $107.15 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $91.20 / $154.88