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Illinois 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 $68 · 10th–90th $24–$680%50%10th$68Professionalmedian $40 · 10th–90th $23–$710%5%10%10th90th$40$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
$18.20 / $30.20 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $36.31 / $63.10
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $50.12 / $58.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $54.95 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $60.26 / $91.20
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $63.10 / $162.18
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $100.00 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $48.98 / $74.13