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Colorado 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 $251 · 10th–90th $170–$2510%20%40%10th$251Professionalmedian $234 · 10th–90th $151–$5010%5%10%10th90th$234$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 / $169.82 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $229.09 / $489.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$218.78 / $323.59 / $630.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $263.03 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $295.12 / $446.68
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $776.25 / $831.76
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $281.84 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $478.63