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Washington, DC 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 $200 · 10th–90th $132–$2000%20%40%10th$200Professionalmedian $186 · 10th–90th $112–$3720%10%10th90th$186$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
$131.83 / $131.83 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $229.09 / $416.87
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $194.98 / $467.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $186.21 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $645.65 / $741.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $173.78 / $380.19