Transitional Care Management Services For Problem Of At Least Moderate Complexity in Florida
Transitional Care Management Services For Problem Of At Least Moderate Complexity in Florida · the short answer
Medicare pays $143.15 on average for transitional care management services for problem of at least moderate complexity in Florida, 4% above the $137.52 national average across all states.
- $143.15
- FL Medicare avg
- $137.52
- National Medicare avg
- 4% above
- vs. national average
State and national averages are computed directly from CMS Medicare Physician & Other Practitioners claims data, 2023.
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Florida
| Provider | Medicare | Services |
|---|---|---|
| Freeman, Olga MD | $161.77 | 229 |
| Cappleman, John M.D. | $156.57 | 191 |
| Mediratta, Nibha MD | $152.82 | 182 |
| Bonomo, Gabriella M.D. | $160.47 | 171 |
| Yelamanchi, Nalini MD | $157.75 | 169 |
| Sibia, Rooptaz M.D. | $54.35 | 163 |
| Tompkins, Brice MD | $163.16 | 130 |
| Luthra, Venu MD | $155.49 | 118 |
| Patel, Rahul M D | $161.66 | 107 |
| Goldstein, Gary M.D. | $155.08 | 106 |
| Mirza, Haris MD | $155.22 | 106 |
| Hill, John MD | $157.46 | 104 |
| Cohen, Aaron M.D. | $77.77 | 104 |
| Alfonso, Renato M.D. | $154.87 | 103 |
| Reichel, David M.D. | $157.08 | 99 |
| Wanger, Michael MD | $156.60 | 98 |
| Gutierrez, Robert D.O. | $149.81 | 97 |
| Hanrahan, Beth MD | $152.65 | 94 |
| Lichtinger, David D.O. | $149.67 | 91 |
| Chadha, Tejvir MD | $160.48 | 91 |
| Farach, Carlos M.D. | $146.94 | 90 |
| Riazudeen, Shahul MD | $158.01 | 90 |
| Ugarte, Julio M.D. | $50.38 | 86 |
| Zopo, Alex M.D. | $51.43 | 85 |
| Camogliano, Romulo M.D. | $156.73 | 84 |
Florida Pricing in Context
In Florida, CPT code 99495 (Transitional Care Management Services For Problem Of At Least Moderate Complexity) carries an average Medicare payment of $143.15 - 4% above the national benchmark of $137.52. 7.2K providers across the state submitted claims for this procedure in 2023, performing 64.9K total services. Payment ranges by individual claim are not published in this CMS extract; the state average above is the figure to compare against the national benchmark.
The average billed charge in Florida is $376.30, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount, the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Florida sits above the national Medicare average, commercial rates in the state may also run higher than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Care Management procedures, the estimated commercial insurance price in Florida lands near $434.29, with self-pay cash prices typically around $242.08. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does Transitional Care Management Services For Problem Of At Least Moderate Complexity cost in Florida?
The average Medicare payment for Transitional Care Management Services For Problem Of At Least Moderate Complexity in Florida is $143.15, which is 4% above the national average of $137.52. Providers in FL typically bill $376.30 for this procedure.
What does Transitional Care Management Services For Problem Of At Least Moderate Complexity cost with insurance in Florida?
With commercial insurance in Florida, Transitional Care Management Services For Problem Of At Least Moderate Complexity costs an estimated $434.29. Without insurance, the estimated cash price is $242.08. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Transitional Care Management Services For Problem Of At Least Moderate Complexity in Florida?
7.2K providers in Florida billed Medicare for Transitional Care Management Services For Problem Of At Least Moderate Complexity in 2023, performing 64.9K total services. The state Medicare average for this code is $143.15.
Is Transitional Care Management Services For Problem Of At Least Moderate Complexity cheaper in Florida than the national average?
No - Transitional Care Management Services For Problem Of At Least Moderate Complexity costs 4% above the national average in Florida. The state average Medicare payment is $143.15 compared to $137.52 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology - how this data is sourced, computed, and verified.
Related
Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, the data changelog, or report a data error.