go back

Home Visit, New Patient, Most Extensive

Pennsylvania rates for HCPCS 99345

A clinician's first visit to a patient at home in its most demanding form, used when the person is unstable or has a significant new problem that needs urgent, detailed assessment. It covers a full history, thorough examination, and decisions that carry real risk, made outside a clinical setting. It applies to someone not previously seen by the practice.

Rates data updated July 2026.

How much does Home Visit, New Patient, Most Extensive cost?

$200

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $200 for this service. Most negotiated rates run $170 to $229.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 11 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $200 · 10th to 90th $148 to $275
$200$500professional $200

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$199.53
Typical High
$269.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$208.93
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$229.09
Typical High
$354.81
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$288.40
Typical High
$354.81
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$199.53
Typical High
$263.03
Optum
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$199.53
Typical High
$218.78
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$234.42
Typical High
$371.54

Where Pennsylvania sits

The same service costs 2.3 times more in Montana than in Mississippi. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 24th of 51

$200

MT $347MS $148

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.