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Arizona rates for HCPCS 99495

Transitional care management services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge, At least moderate level of medical decision making during the service period, Face-to-face visit, within 14 calendar days of discharge

Facilitymedian $170 · 10th–90th $115–$5130%10%10th90th$170Professionalmedian $182 · 10th–90th $112–$4370%10%10th90th$182$50.0$100.0$200.0$500.0$1.0K

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
$131.83 / $134.90 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $426.58
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $323.59 / $602.56
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $263.03
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$204.17 / $204.17 / $338.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $446.68 / $851.14
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $181.97 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $162.18 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $239.88 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $169.82 / $288.40