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Nationwide rates for HCPCS G2064

Comprehensive care management services for a single high risk disease, e.g., principal care management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization, the condition requires development or revision of disease specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities

Facilitymedian $186 · 10th–90th $98$6030%20%10th90th$186Professionalmedian $95 · 10th–90th $74$1290%20%10th90th$95$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
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $309.03 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $100.00 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $93.33 / $134.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $91.20 / $134.90