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South Dakota 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 $123 · 10th–90th $120–$2950%50%10th90th$123Professionalmedian $269 · 10th–90th $158–$6760%10%10th90th$269$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
$120.23 / $123.03 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $724.44
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$269.15 / $275.42 / $676.08
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $190.55 / $295.12
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $436.52 / $645.65
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $239.88 / $426.58
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $436.52 / $1,737.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $309.03 / $436.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $346.74 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $363.08 / $616.60
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $275.42 / $407.38