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Illinois 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 $234 · 10th–90th $54–$4470%10%10th90th$234Professionalmedian $245 · 10th–90th $155–$4790%10%10th90th$245$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$35.48 / $234.42 / $389.05
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$165.96 / $165.96 / $169.82
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
$208.93 / $338.84 / $549.54
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$186.21 / $275.42 / $346.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $229.09 / $3,019.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $295.12 / $446.68
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $302.00 / $562.34
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $234.42 / $371.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $316.23 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $263.03 / $389.05