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South Carolina 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 $229 · 10th–90th $120–$4070%10%20%10th90th$229Professionalmedian $257 · 10th–90th $158–$5130%10%10th90th$257$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
$47.86 / $229.09 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $257.04 / $512.86
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$199.53 / $295.12 / $512.86
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $257.04 / $281.84
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$239.88 / $281.84 / $281.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $263.03 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $263.03 / $389.05
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $302.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $891.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $234.42 / $363.08