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Ohio 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
$27.17 / $36.75 / $156.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.17 / $36.75 / $48.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.30 / $39.68 / $63.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.08 / $31.35 / $45.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.44 / $45.53 / $77.97
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.46 / $46.13 / $76.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.98 / $71.16 / $101.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.42 / $55.74 / $85.36