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HCPCS S9455

HC DIABETES MGMT PROG, GROUP

Reported by 11 hospitals in the network under the case rate methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$26

Average

$54

Median

$43

High

$130

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$66$66$66$1.6k—
2Trinity Medical CenterRock Island, IL$66$66$66$839—
3Unity HealthcareMuscatine, IA$66$66$66$871—
4Ukiah Adventist HospitalUkiah, CA$28$31$30$73$1
5Adventist Health Medical Center TehachapiTehachapi, CA$10$28$29$68$2
6Sonora Community HospitalSonora, CA$33$44$43$98$2
7Glendale Adventist Medical CenterGlendale, CA$46$83$80$385$4
8San Joaquin Community HospitalBakersfield, CA$25$35$34$134$2
9White Memorial Medical CenterAngeles, CA$60$134$130$1.0k$6
10St Helena HospitalHelena, CA$16$27$26$37$1
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