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Massachusetts 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 $191 · 10th–90th $107–$4170%20%10th90th$191Professionalmedian $186 · 10th–90th $110–$4370%10%20%10th90th$186$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$107.15 / $190.55 / $489.78
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $169.82 / $380.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $302.00 / $616.60
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $323.59 / $891.25
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $229.09 / $562.34
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $363.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $204.17 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $269.15 / $467.74
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $173.78 / $245.47
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $251.19 / $371.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $245.47 / $457.09
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $269.15 / $302.00
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $323.59 / $891.25
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $229.09 / $562.34
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $371.54
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $162.18 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $245.47 / $562.34