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New Jersey 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 $204 · 10th–90th $81–$3890%10%10th90th$204Professionalmedian $240 · 10th–90th $148–$4680%10%10th90th$240$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
$81.28 / $181.97 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $457.09
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $275.42 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $288.40 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $288.40 / $478.63
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $457.09
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $416.87 / $660.69
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $257.04 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $229.09 / $398.11