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Nationwide rates for HCPCS 99496

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, High level of medical decision making during the service period, Face-to-face visit, within 7 calendar days of discharge

Facilitymedian $245 · 10th–90th $126–$5010%20%10th90th$245Professionalmedian $245 · 10th–90th $151–$5130%20%10th90th$245$0.0$0.5$10.0$200.0$5.0K$100.0K$2.0M

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
$117.49 / $223.87 / $457.09
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$97.72 / $199.53 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $234.42 / $489.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$208.93 / $316.23 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $295.12 / $707.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $239.88 / $436.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $812.83 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $302.00 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $251.19 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $251.19 / $436.52

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