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Arizona 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 $229 · 10th–90th $151–$7410%10%10th90th$229Professionalmedian $245 · 10th–90th $155–$5620%5%10%10th90th$245$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
$131.83 / $181.97 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $537.03
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $323.59 / $812.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $295.12 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$251.19 / $275.42 / $346.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $660.69 / $1,258.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $389.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $218.78 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $323.59 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $229.09 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $234.42 / $389.05