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Michigan 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 $74–$2190%20%10th90th$126Professionalmedian $182 · 10th–90th $115–$4170%10%10th90th$182$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
$74.13 / $125.89 / $213.80
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $173.78 / $407.38
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $263.03 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $204.17 / $323.59
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $204.17 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $151.36 / $204.17
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $97.72 / $131.83
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $199.53 / $380.19
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $144.54 / $426.58
Health Alliance Plan
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $186.21 / $331.13
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $257.04 / $562.34
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $186.21 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $223.87 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $234.42