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Texas 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 $25–$690%10%10th90th$46Professionalmedian $37 · 10th–90th $23–$550%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
$23.99 / $38.02 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $37.15 / $53.70
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 / $51.29 / $58.88
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$45.71 / $53.70 / $56.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $35.48 / $51.29
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $58.88 / $134.90
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $40.74 / $56.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $50.12 / $79.43
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $45.71 / $69.18
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $38.02 / $56.23
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $54.95 / $87.10
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $45.71 / $69.18
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $50.12 / $81.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $44.67 / $72.44
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $58.88 / $69.18