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Wisconsin 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 $123–$5250%10%10th90th$229Professionalmedian $295 · 10th–90th $158–$7240%5%10%10th90th$295$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
$123.03 / $123.03 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $263.03 / $707.95
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $363.08 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $331.13 / $616.60
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $134.90 / $138.04
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $870.96 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $501.19 / $812.83
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $229.09 / $346.74
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $478.63 / $741.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $229.09 / $354.81
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $478.63 / $1,737.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $398.11
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $323.59 / $630.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $398.11 / $758.58
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $1,202.26
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $524.81 / $1,737.80
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $331.13
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $389.05 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $346.74 / $616.60