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Care Management Home Visit, New Patient, 20 Minutes

Pennsylvania rates for HCPCS G0076

Brief (20 minutes) care management home visit for a new patient. For use only in a Medicare-approved CMMI model (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)

Rates data updated October 2026.

How much does Care Management Home Visit, New Patient, 20 Minutes cost?

$50.12

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $50.12 for this service. The price depends on where it is billed: about $50.12 from a physician practice, and about $60.26 from a hospital or other facility.

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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$50.12$47.86 to $52.48
FacilityA hospital or hospital-owned outpatient department$60.26$58.88 to $5,012

How much rates vary

Facilitymedian $60 · 10th to 90th $48 to $5,012Professionalmedian $50 · 10th to 90th $48 to $59
$100$1K$10K$100Kfacility $60professional $50

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$58.88
Typical High
$58.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$47.86
Typical High
$58.88
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$23.99
Median
$23.99
Typical High
$29.51
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$9.55
Median
$9.55
Typical High
$11.75
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$7.24
Median
$7.24
Typical High
$8.91
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$4.79
Median
$4.79
Typical High
$5.89
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$50.12
Median
$51.29
Typical High
$51.29
Cigna
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Geisinger
Setting
Professional
Modifier
None
Typical Low
$36.31
Median
$38.90
Typical High
$66.07
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$47.86
Typical High
$58.88
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$23.99
Median
$23.99
Typical High
$29.51
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$9.55
Median
$9.55
Typical High
$11.75
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$7.24
Median
$7.24
Typical High
$8.91
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$4.79
Median
$4.79
Typical High
$5.89
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$60.26
Typical High
$60.26
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$50.12
Typical High
$60.26
United
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$57.54
Typical High
$102.33

Where Pennsylvania sits

The same service costs 2.2 times more in Alaska than in Arizona. 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· 37th of 51

$50.12

AK $91.20AZ $40.74

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.