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Chronic Condition Management By Your Own Clinician

Texas rates for HCPCS 99491

This covers a monthly block of time that a physician or other qualified clinician personally spends managing a patient's two or more ongoing chronic health conditions, rather than delegating that work to clinical staff. It typically involves reviewing the patient's overall health status, adjusting treatment plans, and coordinating with other providers involved in the patient's care. It applies to conditions expected to last at least several months or for the rest of the patient's life.

Facilitymedian $83 · 10th–90th $62$2820%10%10th90th$83Professionalmedian $69 · 10th–90th $60$930%20%10th90th$69$50.0$100.0$200.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$69.18
Typical High
$104.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$69.18
Typical High
$91.20
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$87.10
Typical High
$95.50
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$87.10
Median
$87.10
Typical High
$93.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$229.09
Typical High
$416.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$69.18
Typical High
$81.28
Christus
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$70.79
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$89.13
Typical High
$138.04
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$72.44
Typical High
$100.00
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$70.79
Typical High
$114.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
Providence
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$72.44
Typical High
$100.00
Providence
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$134.90
United
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$131.83
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$89.13
Typical High
$125.89
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$91.20
Typical High
$107.15