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Wisconsin 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
$33.11 / $66.07 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $38.02 / $63.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $56.23 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $147.91 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $100.00 / $134.90
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $42.66 / $63.10
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $89.13 / $141.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $42.66 / $63.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $97.72 / $302.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $72.44 / $138.04
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $218.78
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $102.33 / $302.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $70.79 / $97.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $70.79 / $123.03