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California 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 $288 · 10th–90th $229–$6760%10%10th90th$288Professionalmedian $282 · 10th–90th $166–$7760%10%10th90th$282$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
$169.82 / $257.04 / $724.44
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$162.18 / $162.18 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $758.58
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$208.93 / $354.81 / $1,023.29
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $281.84 / $478.63
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$239.88 / $269.15 / $309.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $288.40 / $724.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $309.03 / $562.34
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $316.23 / $398.11
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $269.15 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $275.42 / $501.19
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $467.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $245.47 / $398.11
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $398.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $229.09 / $389.05
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $275.42 / $501.19
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $245.47 / $549.54