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Massachusetts 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 $275 · 10th–90th $155–$8130%20%10th90th$275Professionalmedian $251 · 10th–90th $151–$5750%10%20%10th90th$251$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$151.36 / $436.52 / $812.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $549.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$223.87 / $316.23 / $891.25
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $389.05 / $1,202.26
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $316.23 / $758.58
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $489.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $275.42 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $363.08 / $630.96
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $239.88 / $354.81
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $338.84 / $501.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $331.13 / $616.60
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $371.54 / $478.63
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $389.05 / $1,202.26
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $316.23 / $758.58
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $269.15 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $331.13 / $776.25