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Texas rates for HCPCS 99437

Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; each additional 30 minutes by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Facilitymedian $50 · 10th–90th $41–$720%10%20%10th90th$50Professionalmedian $49 · 10th–90th $40–$660%10%20%10th90th$49$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $48.98 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $48.98 / $61.66
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $61.66
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $47.86 / $57.54
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $46.77 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $64.57 / $97.72
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $50.12 / $69.18
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $75.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $50.12 / $69.18
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $63.10 / $97.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $93.33 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $61.66 / $91.20
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $64.57 / $75.86