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Wisconsin 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 $174 · 10th–90th $120$3890%10%20%10th90th$174Professionalmedian $234 · 10th–90th $117$5500%10%10th90th$234$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
$120.23 / $128.82 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $194.98 / $524.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$190.55 / $354.81 / $660.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $457.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $100.00
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $645.65 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $371.54 / $602.56
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $257.04
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $346.74 / $524.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $173.78 / $281.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $346.74 / $1,288.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $269.15
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $239.88 / $478.63
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $295.12 / $562.34
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $891.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $389.05 / $1,288.25
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $245.47
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $288.40 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $251.19 / $457.09