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Pennsylvania rates for HCPCS 99493

Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation, participation in weekly caseload consultation with the psychiatric consultant, ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers, additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant, provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies, monitoring of patient outcomes using validated rating scales, and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment.

Facilitymedian $316 · 10th–90th $100–$4170%20%10th90th$316Professionalmedian $110 · 10th–90th $72–$1860%10%10th90th$110$20.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $316.23 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $107.15 / $186.21
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $123.03 / $245.47
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $173.78 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $141.25 / $223.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $204.17 / $302.00
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $144.54 / $263.03
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $131.83 / $173.78
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $338.84 / $416.87
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $114.82 / $213.80
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $275.42
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $134.90 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $123.03 / $204.17