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Utah 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
$36.31 / $47.86 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $37.15 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $54.95 / $81.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $83.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $52.48 / $70.79
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $51.29 / $63.10
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $51.29 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $47.86 / $70.79