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North Carolina 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 $46 · 10th–90th $26–$790%5%10%10th90th$46Professionalmedian $42 · 10th–90th $25–$790%10%10th90th$42$20.0$50.0$100.0$200.0$500.0

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 / $69.18 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $39.81 / $72.44
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
$38.90 / $47.86 / $58.88
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $45.71 / $54.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $46.77 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $58.88 / $100.00
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $42.66 / $66.07
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $52.48 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $47.86 / $79.43
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03