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Indiana 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 $178 · 10th–90th $105–$5500%10%10th90th$178Professionalmedian $191 · 10th–90th $112–$3720%10%10th90th$191$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
$100.00 / $177.83 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $186.21 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $275.42 / $660.69
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $239.88 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$144.54 / $234.42 / $316.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $407.38 / $549.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $263.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $165.96
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $204.17 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $251.19