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Hawaii 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 $151 · 10th–90th $151–$1550%50%100%90th$151Professionalmedian $170 · 10th–90th $115–$3890%10%20%10th90th$170$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $389.05
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $239.88 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $213.80 / $288.40
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $239.88 / $281.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $208.93 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $199.53 / $239.88
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $190.55 / $426.58