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Pennsylvania 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
$29.84 / $40.94 / $78.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.86 / $37.32 / $48.46
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.36 / $53.30 / $76.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.04 / $49.48 / $72.41
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.03 / $79.03 / $79.03
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.84 / $40.94 / $1,812.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.69 / $39.97 / $58.50
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.11 / $50.34 / $75.09
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.11 / $38.36 / $51.59
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.11 / $44.77 / $51.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.73 / $58.78 / $90.65