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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 July 2026.

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

$48.98

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $48.98 from a physician practice, and about $58.88 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$48.98$45.71 to $54.95
FacilityA hospital or hospital-owned outpatient department$58.88$58.88 to $58.88

How much rates vary

Facilitymedian $59 · 10th to 90th $59 to $60Professionalmedian $49 · 10th to 90th $37 to $62
$100.0$1.0K$10.0Kfacility $59professional $49

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
Facility
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$48.98
Typical High
$61.66
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$51.29
Typical High
$95.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$38.90
Typical High
$64.57
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$50.12
Typical High
$61.66
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$60.26
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$47.86
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$63.10
Typical High
$102.33

Where Pennsylvania sits

The same service costs 1.9 times more in North Dakota than in Louisiana. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $48.98 · 38th of 51
ND $83.18LA $44.67

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.