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California 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 $50 · 10th–90th $28–$740%10%10th90th$50Professionalmedian $43 · 10th–90th $26–$890%10%10th90th$43$20.0$50.0$100.0$200.0$500.0

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
$28.84 / $43.65 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $41.69 / $81.28
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $48.98 / $66.07
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $50.12 / $51.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $70.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $91.20 / $158.49
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $53.70 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $54.95 / $117.49
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $69.18 / $93.33
HealthNet
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $66.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $47.86 / $75.86
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $54.95 / $87.10
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $47.86 / $74.13
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $57.54 / $114.82
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $123.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $46.77 / $102.33