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North Carolina 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
$34.65 / $46.54 / $72.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.84 / $37.86 / $49.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.49 / $41.39 / $100.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.85 / $57.11 / $97.09
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.47 / $39.65 / $55.60
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.82 / $40.82 / $51.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.57 / $58.35 / $94.20
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.97 / $174.80 / $174.80
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.48 / $218.48 / $298.80