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Care Management Home Visit, New Patient, 30 Minutes

Pennsylvania rates for HCPCS G0077

Limited (30 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, 30 Minutes cost?

$74.13

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $74.13 for this service. The price depends on where it is billed: about $72.44 from a physician practice, and about $83.18 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$72.44$67.61 to $77.62
FacilityA hospital or hospital-owned outpatient department$83.18$83.18 to $83.18

How much rates vary

Facilitymedian $83 · 10th to 90th $83 to $87Professionalmedian $72 · 10th to 90th $54 to $87
$100$1K$10Kfacility $83professional $72

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
$83.18
Median
$83.18
Typical High
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$72.44
Typical High
$87.10
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
$74.13
Median
$77.62
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$58.88
Typical High
$91.20
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$74.13
Typical High
$87.10
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$87.10
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$72.44
Typical High
$87.10
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$91.20
Typical High
$147.91

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. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 35th of 51

$74.13

ND $126LA $67.61

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.