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Kentucky 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 $195 · 10th–90th $138–$3090%10%20%10th90th$195Professionalmedian $234 · 10th–90th $151–$4470%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
$162.18 / $234.42 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $234.42 / $446.68
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$186.21 / $302.00 / $660.69
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$186.21 / $239.88 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $263.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $173.78 / $251.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $257.04 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $295.12 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $275.42 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $346.74