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New Jersey 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 $195 · 10th–90th $68–$3550%10%10th90th$195Professionalmedian $170 · 10th–90th $107–$3630%10%10th90th$170$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
$120.23 / $194.98 / $281.84
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $162.18 / $354.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$112.20 / $239.88 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $218.78 / $389.05
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $245.47 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $204.17 / $354.81
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $338.84
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $416.87 / $660.69
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $165.96 / $288.40