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New York 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 $50 · 10th–90th $35–$1230%10%10th90th$50Professionalmedian $39 · 10th–90th $23–$780%5%10%10th90th$39$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
$34.67 / $50.12 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $38.90 / $70.79
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $46.77 / $58.88
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $32.36 / $81.28
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $60.26 / $128.82
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $61.66
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $109.65
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $57.54 / $114.82
Fidelis
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $67.61 / $194.98
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $57.54 / $63.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $47.86 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $58.88 / $134.90
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $53.70 / $53.70
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $57.54 / $112.20