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Texas 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 $141$4370%10%10th90th$229Professionalmedian $219 · 10th–90th $151$3890%10%10th90th$219$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
$125.89 / $204.17 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $218.78 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$194.98 / $363.08 / $741.31
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $263.03 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$223.87 / $263.03 / $331.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $316.23 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $269.15
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $257.04
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $302.00 / $380.19
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $257.04 / $389.05
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $218.78 / $316.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $218.78 / $398.11
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$194.98 / $363.08 / $575.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $125.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $218.78 / $316.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $251.19 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $239.88 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $223.87 / $338.84
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $302.00 / $363.08