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Iowa 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 $51 · 10th–90th $27–$780%10%10th90th$51Professionalmedian $35 · 10th–90th $22–$550%5%10%10th90th$35$20.0$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 / $53.70 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $33.88 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $85.11 / $177.83
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $52.48 / $138.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $40.74 / $83.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $81.28 / $323.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $81.28 / $117.49
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $117.49
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $52.48 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $53.70 / $91.20
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $61.66 / $77.62