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Montana 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 $224 · 10th–90th $123–$3550%10%20%10th90th$224Professionalmedian $186 · 10th–90th $115–$4470%10%10th90th$186$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$123.03 / $128.82 / $162.18
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $436.52
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $181.97 / $575.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $218.78 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $323.59 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $218.78 / $331.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $269.15 / $363.08
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $269.15 / $363.08
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $165.96 / $263.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $194.98 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $251.19 / $354.81