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South Dakota 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 $135 · 10th–90th $24–$3390%20%10th90th$135Professionalmedian $200 · 10th–90th $120–$5010%10%10th90th$200$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
$23.99 / $134.90 / $338.84
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$229.09 / $257.04 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $199.53 / $489.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $501.19 / $549.54
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $218.78
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $338.84 / $478.63
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $309.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $309.03 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $208.93 / $309.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $251.19 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $269.15 / $446.68
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $204.17 / $302.00