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Pennsylvania 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.71 / $217.56 / $426.81
Aetna
Facility/Professional
Facility
Modifier
25
Low / Median / High Price
$163.76 / $163.76 / $163.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.72 / $220.22 / $450.00
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$129.97 / $306.63 / $772.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$412.58 / $412.58 / $425.99
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.86 / $312.70 / $325.33
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.10 / $8,459.92 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.41 / $300.83 / $438.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.03 / $261.69 / $388.53
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.12 / $428.12 / $428.12
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.54 / $578.51 / $743.97
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.86 / $303.64 / $325.33
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.71 / $217.56 / $506.05
Martin's Point
Facility/Professional
Facility
Modifier
25
Low / Median / High Price
$163.76 / $163.76 / $163.76
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.19 / $262.87 / $452.17
Martin's Point
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$150.27 / $351.57 / $497.33
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.03 / $261.69 / $388.53
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.56 / $186.38 / $267.95
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.56 / $206.17 / $283.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $287.88 / $468.98