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Massachusetts 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 $52 · 10th–90th $27–$710%10%10th90th$52Professionalmedian $42 · 10th–90th $24–$980%5%10%10th90th$42$10.0$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
$32.36 / $52.48 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $38.90 / $70.79
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $63.10 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $66.07 / $85.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $64.57 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $66.07 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $38.90 / $67.61
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $60.26 / $104.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $72.44 / $134.90
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $63.10 / $309.03
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $46.77
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $61.66 / $151.36