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Wisconsin rates for HCPCS G2058

Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (Do not report G2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month.) (Use G2058 in conjunction with 99490.) (Do not report 99490, G2058 in the same calendar month as 99487, 99489, 99491.)

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.72 / $109.52 / $168.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.04 / $48.57 / $73.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.45 / $81.45 / $126.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.40 / $58.40 / $58.40
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $65.00 / $90.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.45 / $81.45 / $126.66
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.70 / $37.28 / $49.48