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Ohio 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 $39 · 10th–90th $29–$1150%10%20%10th90th$39Professionalmedian $37 · 10th–90th $23–$630%10%10th90th$37$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
$25.12 / $36.31 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $36.31 / $58.88
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
$36.31 / $48.98 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $45.71 / $74.13
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $40.74 / $54.95
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $52.48 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $52.48 / $83.18
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $51.29 / $74.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $52.48 / $87.10
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $57.54 / $81.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $45.71 / $74.13