Preview of prices split by billing class

Care management for one high-risk chronic condition CPT 99426

A hospital usually bills a facility fee (its own: room, staff, supplies) and, for some, a separate professional fee (the clinician’s). The main code page averages the two. These views keep them apart.

What a typical hospital charges

$174median estimated total, 46 hospitals that file both fees

Facility $116 · 67%Pro $57 · 33%

The typical split across the 46 hospitals that file both. Select a share for that fee on its own.

Facility average plus professional average, for the 46 hospitals that file both under fee schedule · outpatient. An estimate for this code only: anesthesia, radiology and pathology are billed under other codes, and independent groups may bill separately and not appear in a hospital's file. The median is across those hospitals' totals, which is not the sum of the facility and professional medians.

Hospitals

7 sets of terms with fewer hospitals are not listed.

Of 1,036 hospitals with any price for this code, only those filing both a facility and a professional price on these terms appear here; the rest file another methodology or setting, or no billing class. 716 of them file neither class on these terms.

Showing 1–25 of 46

Hospital	Facility	Professional	Estimated total	Split
Mayo Regional Hospital Dover Foxcroft, ME	$463	$71	$535
Charles A. Dean Memorial Hospital Greenville, ME	$420	$78	$498

Price distribution

Estimated totalFee schedule · Outpatient

46 hospitals; the 90th percentile is 2.3× the 10th.