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California 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 $195 · 10th–90th $158–$4570%10%20%10th90th$195Professionalmedian $195 · 10th–90th $112–$5750%5%10%10th90th$195$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
$120.23 / $177.83 / $537.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $549.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$141.25 / $251.19 / $616.60
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $204.17 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $204.17 / $213.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $199.53 / $501.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $398.11
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $316.23 / $398.11
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $371.54
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $204.17 / $346.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $181.97 / $295.12
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $295.12
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $288.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $371.54
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $407.38