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West Virginia 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 $282 · 10th–90th $112–$3800%20%10th90th$282Professionalmedian $200 · 10th–90th $112–$4170%10%10th90th$200$20.0$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
$112.20 / $251.19 / $380.19
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$288.40 / $295.12 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $199.53 / $426.58
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$151.36 / $354.81 / $416.87
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $134.90 / $177.83
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $190.55 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $204.17 / $977.24
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $177.83 / $524.81
Highmark BCBS
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$245.47 / $416.87 / $549.54
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $151.36 / $229.09
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$204.17 / $204.17 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $288.40