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Oregon 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 $355 · 10th–90th $178–$5500%10%20%10th90th$355Professionalmedian $269 · 10th–90th $158–$6610%10%20%10th90th$269$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
$257.04 / $426.58 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $630.96
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$208.93 / $295.12 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $467.74 / $741.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $407.38 / $660.69
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $234.42 / $389.05
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $380.19 / $691.83
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$208.93 / $295.12 / $831.76
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $457.09 / $549.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $380.19
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $338.84 / $602.56
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $524.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $467.74 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $501.19 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $380.19 / $630.96