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Maryland 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 $166 · 10th–90th $138–$2400%10%20%10th90th$166Professionalmedian $170 · 10th–90th $110–$3630%10%10th90th$170$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
$158.49 / $158.49 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $165.96 / $363.08
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $218.78 / $416.87
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $194.98 / $338.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $186.21 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $165.96 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $295.12
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $234.42 / $331.13