Transitional care visit within 2 days of discharge at St Helena Hospital

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

Transitional care management services for problem of high complexity

Helena, CA

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Pricing by billing methodology

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How this price compares nationally

St Helena Hospital’s median price of $217 is 17% above the median hospital's median price ($186), higher than 65% of the 1,604 hospitals reporting CPT 99496. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99496 at St Helena Hospital

Negotiated rates from the hospital’s own file: 7 payers, 36 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	UnitedHealthcare uhc select/select plus percent of total billed charges · outpatientfrom % of charges	$163	$163	—	—	—	$163 – $163
2	Blue Cross Blue Shield blue shield behav hlth percent of total billed charges · outpatientfrom % of charges	$166	$166	—	—	—	$166 – $166
3	Blue Cross Blue Shield blue shield non-epn percent of total billed charges · outpatientfrom % of charges	$171	$171	—	—	—	$171 – $171
4	Blue Cross Blue Shield blue shield epn-all other plans percent of total billed charges · outpatientfrom % of charges	$173	$173	—	—	—	$173 – $173
5	UnitedHealthcare uhc jll percent of total billed charges · outpatientfrom % of charges	$176	$176	—	—	—	$176 – $176
6	Blue Cross Blue Shield blue shield bh mcr adv other · outpatient	$177	$177	—	—	—	$177 – $177
7	Blue Cross Blue Shield blue shield mcr adv other · outpatient	$177	$177	—	—	—	$177 – $177
8	Blue Cross Blue Shield tricare blue shield other · outpatient	$177	$177	—	—	—	$177 – $177
9	Kaiser kaiser mcr adv other · outpatient	$177	$177	—	—	—	$177 – $177
10	UnitedHealthcare uhc mcr adv other · outpatient	$177	$177	—	—	—	$177 – $177
11	Blue Cross Blue Shield blue shield bh mcr adv fee schedule · outpatient	$180	$180	—	—	—	$180 – $180
12	Blue Cross Blue Shield blue shield mcr adv fee schedule · outpatient	$180	$180	—	—	—	$180 – $180
13	Blue Cross Blue Shield tricare blue shield fee schedule · outpatient	$180	$180	—	—	—	$180 – $180
14	Kaiser kaiser mcr adv fee schedule · outpatient	$180	$180	—	—	—	$180 – $180
15	UnitedHealthcare uhc all payer - all other plans percent of total billed charges · outpatientfrom % of charges	$185	$185	—	—	—	$185 – $185
16	Aetna aetna-all plans percent of total billed charges · outpatientfrom % of charges	$191	$191	—	—	—	$191 – $191
17	Cigna cigna-all other plans fee schedule · outpatient	$198	$198	—	—	—	$198 – $198
18	UnitedHealthcare uhc all payer - all other plans fee schedule · outpatient	$209	$209	—	—	—	$209 – $209
19	UnitedHealthcare uhc jll fee schedule · outpatient	$209	$209	—	—	—	$209 – $209
20	UnitedHealthcare uhc options ppo fee schedule · outpatient	$209	$209	—	—	—	$209 – $209
21	UnitedHealthcare uhc select/select plus fee schedule · outpatient	$209	$209	—	—	—	$209 – $209
22	Phcs phcs-all plans percent of total billed charges · outpatientfrom % of charges	$216	$216	$13	6%	—	$202 – $229
23	Kaiser kaiser-all other plans fee schedule · outpatient	$217	$217	—	—	—	$217 – $217
24	UnitedHealthcare umr uhc ppo percent of total billed charges · outpatientfrom % of charges	$234	$234	—	—	—	$234 – $234
25	UnitedHealthcare uhc options ppo percent of total billed charges · outpatientfrom % of charges	$235	$235	—	—	—	$235 – $235

Page 1 of 2 · 36 rates

Last updated: Jul 15, 2026

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