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South Dakota 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 $35 · 10th–90th $24–$540%10%20%10th90th$35Professionalmedian $36 · 10th–90th $23–$560%10%10th90th$36$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
$23.99 / $30.90 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $34.67 / $51.29
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $89.13 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $100.00 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $41.69 / $64.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $269.15 / $323.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $87.10 / $109.65
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $70.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $64.57 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $56.23 / $104.71
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $63.10 / $79.43