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Nebraska 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 $245 · 10th–90th $117–$4170%10%10th90th$245Professionalmedian $195 · 10th–90th $110–$4790%10%10th90th$195$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
$91.20 / $257.04 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $190.55 / $478.63
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$181.97 / $363.08 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $323.59 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$208.93 / $389.05 / $426.58
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $257.04 / $524.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $257.04 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $316.23 / $467.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $186.21 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $316.23 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $302.00 / $398.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $309.03 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $177.83 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $281.84 / $457.09