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South 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 $166 · 10th–90th $112–$2690%10%10th90th$166Professionalmedian $191 · 10th–90th $112–$4070%10%10th90th$191$10.0$20.0$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
$117.49 / $169.82 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $407.38
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $218.78 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $177.83 / $208.93
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $208.93 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $194.98 / $281.84
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $218.78
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $891.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $269.15