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Washington 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 $269 · 10th–90th $162–$5130%5%10%10th90th$269Professionalmedian $269 · 10th–90th $155–$6610%5%10%10th90th$269$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
$131.83 / $338.84 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $269.15 / $707.95
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$75.86 / $295.12 / $851.14
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $416.87 / $616.60
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$263.03 / $288.40 / $436.52
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $354.81 / $724.44
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $371.54 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $389.05 / $616.60
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $245.47 / $446.68
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $234.42 / $416.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $457.09 / $549.54
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $371.54 / $371.54
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $371.54 / $676.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $371.54 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $489.78 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $338.84 / $602.56
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $309.03 / $436.52