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Missouri 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 $219 · 10th–90th $123–$3630%10%20%10th90th$219Professionalmedian $234 · 10th–90th $148–$4370%10%20%10th90th$234$0.0$0.2$2.0$20.0$200.0

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
$120.23 / $208.93 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $229.09 / $446.68
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$245.47 / $316.23 / $512.86
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $269.15 / $295.12
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$204.17 / $251.19 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $194.98 / $346.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $288.40 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $426.58
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $229.09 / $436.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $354.81 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $363.08