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Maine 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 $126 · 10th–90th $112–$2190%20%10th90th$126Professionalmedian $219 · 10th–90th $148–$4370%10%10th90th$219$50.0$200.0$1.0K$5.0K$20.0K

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
$112.20 / $125.89 / $218.78
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $213.80 / $426.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $288.40 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $302.00 / $457.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $275.42 / $549.54
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $213.80 / $398.11
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $213.80 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $309.03 / $446.68