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New Jersey 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 $19–$650%10%10th90th$32Professionalmedian $37 · 10th–90th $23–$660%5%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
$19.05 / $30.20 / $63.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $36.31 / $61.66
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $48.98 / $57.54
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $54.95 / $93.33
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $87.10 / $97.72
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $151.36
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $53.70 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $46.77 / $83.18