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Michigan 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 $32 · 10th–90th $22–$430%10%20%10th90th$32Professionalmedian $37 · 10th–90th $23–$590%10%10th90th$37$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
$21.88 / $30.20 / $42.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $37.15 / $57.54
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
$42.66 / $50.12 / $66.07
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $39.81 / $45.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $42.66 / $63.10
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $40.74 / $54.95
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $63.10 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $61.66 / $128.82
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $32.36 / $46.77
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $37.15 / $58.88
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $52.48 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $44.67 / $61.66