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Kentucky 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 $102–$2290%10%10th90th$145Professionalmedian $170 · 10th–90th $110–$3310%10%10th90th$170$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
$120.23 / $173.78 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $173.78 / $338.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$50.12 / $218.78 / $501.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $218.78 / $288.40
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$144.54 / $223.87 / $281.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $190.55
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $128.82 / $181.97
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $199.53 / $977.24
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $162.18 / $251.19