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Washington 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 $45 · 10th–90th $28–$850%10%10th90th$45Professionalmedian $41 · 10th–90th $25–$720%5%10%10th90th$41$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
$77.62 / $100.00 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $38.02 / $64.57
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
$40.74 / $50.12 / $97.72
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $58.88 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $63.10 / $128.82
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $44.67 / $72.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $43.65 / $72.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $107.15 / $107.15
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $117.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $58.88 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $63.10 / $107.15
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $58.88 / $83.18