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Texas 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
$27.11 / $38.70 / $63.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.84 / $37.09 / $49.43
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $51.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.92 / $103.19 / $193.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.57 / $37.11 / $49.42
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.55 / $51.55 / $51.55
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.08 / $33.33 / $52.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.44 / $46.40 / $75.42
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.47 / $174.80 / $174.80
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.48 / $218.48 / $298.80
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.67 / $38.70 / $55.81
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.72 / $58.03 / $83.26
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.34 / $41.34 / $60.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.64 / $38.61 / $55.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.03 / $48.25 / $76.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.90 / $51.62 / $75.59
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.07 / $48.93 / $68.50