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Missouri 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 $162 · 10th–90th $112–$3090%20%10th90th$162Professionalmedian $170 · 10th–90th $107–$3630%20%10th90th$170$0.0$0.2$2.0$20.0$200.0

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
$112.20 / $158.49 / $269.15
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $169.82 / $363.08
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$186.21 / $239.88 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $218.78
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $186.21 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $138.04 / $251.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $208.93 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $199.53 / $316.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $169.82 / $323.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $309.03 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $177.83 / $263.03