go back

Georgia 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 $148 · 10th–90th $112–$4680%20%10th90th$148Professionalmedian $178 · 10th–90th $112–$3720%10%10th90th$178$10.0$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
$112.20 / $147.91 / $489.78
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $173.78 / $380.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $218.78 / $407.38
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $245.47 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $257.04
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $223.87
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $194.98 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $204.17 / $354.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $223.87 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $186.21 / $363.08