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Oregon 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 $257 · 10th–90th $135–$4070%10%10th90th$257Professionalmedian $191 · 10th–90th $107–$5130%10%10th90th$191$2.0$20.0$200.0$2.0K$20.0K$200.0K

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
$134.90 / $263.03 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $173.78 / $478.63
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$81.28 / $223.87 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $338.84 / $549.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $302.00 / $489.78
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $295.12
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $275.42 / $501.19
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$81.28 / $223.87 / $575.44
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $346.74 / $407.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $275.42
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $245.47 / $446.68
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $524.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $338.84 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $501.19 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $288.40 / $467.74