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Iowa 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 $234 · 10th–90th $115–$3980%10%10th90th$234Professionalmedian $195 · 10th–90th $115–$4900%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
$114.82 / $234.42 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $478.63
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $223.87 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $478.63
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $190.55 / $467.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $208.93 / $489.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $281.84 / $891.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $309.03 / $512.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $309.03 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $363.08
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $204.17 / $295.12