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Maine 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 $126 · 10th–90th $126–$3720%50%90th$126Professionalmedian $162 · 10th–90th $107–$3720%10%10th90th$162$50.0$200.0$1.0K$5.0K$20.0K

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
$125.89 / $125.89 / $186.21
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $162.18 / $371.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $208.93 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $213.80 / $338.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $204.17 / $407.38
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $162.18 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $331.13