CPT 99425

Care management for one serious long-term condition

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR PRIN CARE MGMT MD/APP EA ADDL

Payer pricing summary

Low

Average

$199

Median

$86

High

$3.8k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +15 other terms	115	$171	$190	$73	39%	—	$0 – $380
2	Aetna fee schedule · outpatient · +18 other terms	84	$58	$481	$1.5k	310%	—	$41 – $8.4k
3	Humana fee schedule · outpatient · +16 other terms	84	$58	$82	$45	55%	—	$41 – $186
4	UnitedHealthcare fee schedule · outpatient · +23 other terms	83	$59	$65	$28	43%	—	$10 – $147
5	Anthem fee schedule · outpatient · +13 other terms	64	$57	$110	$142	129%	—	$15 – $615
6	Cigna fee schedule · outpatient · +17 other terms	43	$60	$74	$28	37%	—	$43 – $177
7	Bcbs Tx fee schedule · outpatient	30	$218	$200	$73	37%	—	$64 – $368
8	Kaiser fee schedule · outpatient · +9 other terms	27	$60	$62	$20	32%	—	$44 – $110
9	Molina facility · fee schedule · outpatient · +15 other terms	26	$50	$50	$20	40%	—	$8 – $121
10	Regence professional · fee schedule · outpatient · +5 other terms	26	$53	$89	$44	49%	—	$49 – $181
11	Devoted fee schedule · outpatient · +4 other terms	21	$60	$55	$5	10%	—	$49 – $60
12	Medicare fee schedule · outpatient · +6 other terms	19	$49	$48	$1	3%	—	$44 – $50
13	WellCare fee schedule · both · +10 other terms	19	$49	$57	$13	22%	—	$39 – $97
14	Highmark fee schedule · outpatient · +7 other terms	14	$63	$66	$19	29%	—	$43 – $204
15	Medica fee schedule · outpatient · +7 other terms	13	$171	$162	$56	35%	—	$42 – $228
16	Wellmark fee schedule · both · +3 other terms	13	$66	$66	$10	16%	—	$48 – $74
17	Aetna Better Health fee schedule · outpatient · +5 other terms	12	$42	$48	$7	14%	—	$42 – $56
18	Cigna Healthspring fee schedule · both · +2 other terms	12	$47	$48	$1	1%	—	$47 – $50
19	Ambetter facility · fee schedule · outpatient · +9 other terms	11	$107	$98	$15	16%	—	$59 – $107
20	Caresource facility · fee schedule · outpatient · +8 other terms	11	$107	$94	$25	26%	—	$48 – $118
21	MultiPlan fee schedule · both · +11 other terms	11	$95	$105	$29	28%	—	$80 – $184
22	Medical Mutual facility · fee schedule · outpatient · +5 other terms	10	$59	$73	$15	21%	—	$59 – $94
23	Optum fee schedule · outpatient · +7 other terms	10	$49	$49	$0	1%	—	$49 – $50
24	Oscar fee schedule · outpatient · +5 other terms	10	$44	$48	$43	90%	—	$1 – $107
25	Bcbs Il professional · fee schedule · both · +1 other terms	9	$40	$42	$30	71%	—	$0 – $114

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