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Idaho 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 $145 · 10th–90th $23–$3020%10%10th90th$145Professionalmedian $170 · 10th–90th $105–$3800%10%10th90th$170$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
$23.44 / $134.90 / $302.00
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $169.82 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$81.28 / $251.19 / $398.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $257.04 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $281.84 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $257.04 / $346.74
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $263.03
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $213.80 / $398.11
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$81.28 / $251.19 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $165.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $295.12 / $416.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $263.03 / $331.13
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $281.84