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Georgia 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 $155 · 10th–90th $117–$2290%20%40%10th90th$155Professionalmedian $251 · 10th–90th $155–$4790%10%10th90th$251$10.0$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
$114.82 / $120.23 / $218.78
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$208.93 / $223.87 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $234.42 / $478.63
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$245.47 / $354.81 / $562.34
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $302.00 / $467.74
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$275.42 / $302.00 / $537.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $245.47 / $354.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $204.17 / $302.00
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $263.03 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $478.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $302.00 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $257.04 / $489.78