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Tennessee 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 $234 · 10th–90th $151–$8910%10%20%10th90th$234Professionalmedian $170 · 10th–90th $112–$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
$151.36 / $234.42 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $354.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $239.88 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $213.80 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $181.97 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $194.98 / $288.40
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $891.25 / $891.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $281.84