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Utah 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 $234 · 10th–90th $200–$3090%20%10th90th$234Professionalmedian $219 · 10th–90th $151–$3470%10%10th90th$219$50.0$100.0$200.0$500.0

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
$199.53 / $199.53 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $331.13
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$208.93 / $295.12 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $416.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $251.19 / $389.05
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $275.42 / $363.08
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $281.84 / $389.05
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $309.03 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $363.08