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Washington 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 $186 · 10th–90th $123–$4070%10%10th90th$186Professionalmedian $186 · 10th–90th $107–$5130%5%10%10th90th$186$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
$134.90 / $245.47 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $181.97 / $549.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$50.12 / $281.84 / $616.60
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $158.49 / $208.93
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $354.81 / $724.44
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $275.42 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $281.84 / $457.09
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $173.78 / $323.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $162.18 / $302.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $346.74 / $407.38
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $275.42 / $275.42
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $275.42 / $501.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $363.08 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $275.42 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $489.78 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $251.19 / $446.68
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $223.87 / $316.23