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Utah 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 $162 · 10th–90th $135–$3090%20%10th90th$162Professionalmedian $162 · 10th–90th $100–$2570%10%10th90th$162$50.0$100.0$200.0$500.0

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 / $134.90 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $158.49 / $251.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $199.53 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $213.80 / $309.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $251.19 / $389.05
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $204.17 / $257.04
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $288.40
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $181.97 / $269.15