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Vermont 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 $389 · 10th–90th $389–$4270%20%40%90th$389Professionalmedian $162 · 10th–90th $107–$4070%20%10th90th$162$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $162.18 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $213.80 / $331.13
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $346.74 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $257.04 / $426.58