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Nevada 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 $36 · 10th–90th $27–$370%50%10th90th$36Professionalmedian $38 · 10th–90th $28–$520%10%20%10th90th$38$10.0$20.0$50.0$100.0

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
$26.92 / $26.92 / $37.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $37.15 / $51.29
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $40.74 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $48.98 / $74.13
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $52.48 / $75.86
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $81.28 / $81.28
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $53.70 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $48.98 / $75.86