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Complex Chronic Care Management, First Hour

Pennsylvania rates for HCPCS 99487

This service covers the first hour, per month, of behind-the-scenes care coordination for a person with multiple serious, ongoing health conditions. Clinical staff spend this time each month organizing care between different providers, managing medications, and addressing complex needs that require significant medical decision-making, typically without the patient being present. It reflects a higher level of coordination than routine chronic condition management.

Rates data updated October 2026.

How much does Complex Chronic Care Management, First Hour cost?

$105

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $129 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$105$72.44 to $135
FacilityA hospital or hospital-owned outpatient department$129$89.13 to $562

How much rates vary

Facilitymedian $129 · 10th to 90th $71 to $5,012Professionalmedian $105 · 10th to 90th $71 to $138
$100$1K$10Kfacility $129professional $105

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$104.71
Typical High
$1,412.54
Aetna
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$79.43
Typical High
$104.71
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$35.48
Median
$38.02
Typical High
$52.48
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$138.04
Typical High
$138.04
Cigna
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$112.20
Typical High
$177.83
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Geisinger
Setting
Professional
Modifier
None
Typical Low
$58.88
Median
$109.65
Typical High
$229.09
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$104.71
Typical High
$1,862.09
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$79.43
Typical High
$104.71
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$35.48
Median
$37.15
Typical High
$52.48
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$89.13
Typical High
$128.82
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$100.00
Typical High
$128.82
United
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$524.81
Typical High
$602.56
United
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$89.13
Typical High
$147.91

Where Pennsylvania sits

The same service costs 3.4 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 23rd of 51

$105

AK $219KY $64.57

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.