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Montana 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
Professional
Modifier
Low / Median / High Price
$28.18 / $38.02 / $57.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $74.13 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $63.10 / $97.72
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $66.07 / $83.18
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $66.07 / $83.18
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $42.66 / $70.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $64.57 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $67.61 / $89.13