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Virginia 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 $141–$4170%10%10th90th$234Professionalmedian $229 · 10th–90th $151–$4070%5%10%10th90th$229$20.0$100.0$500.0$2.0K$10.0K

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 / $269.15 / $416.87
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $223.87 / $407.38
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$245.47 / $331.13 / $549.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $398.11
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $190.55 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $269.15 / $398.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $257.04 / $389.05
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $323.59
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $234.42 / $10,000.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $302.00 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $416.87 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $257.04 / $446.68