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Michigan 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 $54–$2950%10%10th90th$126Professionalmedian $229 · 10th–90th $155–$4790%10%10th90th$229$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
$53.70 / $125.89 / $295.12
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $478.63
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$208.93 / $295.12 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $288.40 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$239.88 / $275.42 / $346.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $204.17 / $275.42
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $134.90 / $181.97
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $524.81
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $194.98 / $602.56
Health Alliance Plan
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $416.87
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$208.93 / $295.12 / $478.63
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $263.03 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $223.87 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $239.88 / $331.13