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North Carolina 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 $107–$3310%10%10th90th$162Professionalmedian $178 · 10th–90th $112–$3800%10%10th90th$178$50.0$100.0$200.0$500.0$1.0K

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
$107.15 / $162.18 / $467.74
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $263.03 / $562.34
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $208.93 / $302.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $190.55 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $331.13
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $229.09
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $181.97 / $281.84
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25