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Nationwide rates for HCPCS 99484

Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes, facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation, and continuity of care with a designated member of the care team.

Facilitymedian $45 · 10th–90th $27–$810%10%20%10th90th$45Professionalmedian $38 · 10th–90th $23–$660%10%20%10th90th$38$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$22.91 / $36.31 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $37.15 / $57.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $67.61 / $70.79
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $44.67 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $66.07 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $56.23 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $57.54 / $81.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $50.12 / $89.13
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11

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