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New York rates for HCPCS 99491

Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month.

Facilitymedian $105 · 10th–90th $68–$1660%20%40%10th90th$105Professionalmedian $69 · 10th–90th $55–$1320%20%10th90th$69$50.0$200.0$1.0K$5.0K$20.0K

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
$81.28 / $109.65 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $70.79 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $72.44 / $91.20
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $60.26 / $141.25
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $102.33 / $269.15
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $83.18 / $218.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $144.54 / $194.98
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $79.43 / $79.43
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $89.13 / $154.88
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $109.65 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $269.15 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $93.33 / $199.53
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $72.44 / $102.33
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $93.33 / $154.88