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Texas 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 $178 · 10th–90th $112–$4070%10%10th90th$178Professionalmedian $162 · 10th–90th $112–$3390%10%20%10th90th$162$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
$24.55 / $151.36 / $323.59
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $346.74
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $363.08 / $660.69
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $204.17 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $204.17 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $316.23 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $147.91 / $199.53
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $141.25 / $323.59
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $302.00
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $186.21 / $281.84
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $158.49 / $234.42
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $309.03
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $363.08 / $660.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $158.49 / $234.42
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $181.97 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $234.42 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $165.96 / $251.19
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $223.87 / $263.03