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South Dakota 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
$34.36 / $34.36 / $47.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.84 / $37.86 / $55.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.36 / $96.05 / $118.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.93 / $44.10 / $80.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.08 / $88.90 / $298.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.01 / $70.64 / $92.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.91 / $68.86 / $92.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.14 / $60.14 / $95.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.70 / $88.90 / $96.72
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.60 / $51.70 / $76.00