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Maine 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 $36 · 10th–90th $28–$490%10%20%10th90th$36Professionalmedian $39 · 10th–90th $23–$680%10%10th90th$39$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $36.31 / $48.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $36.31 / $56.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $54.95 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $58.88 / $104.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $60.26 / $120.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $38.02 / $56.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $60.26 / $107.15