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California rates for HCPCS G0078

Moderate (45 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)

Facilitymedian $182 · 10th–90th $148–$4680%10%20%10th90th$182Professionalmedian $126 · 10th–90th $95–$3310%20%10th90th$126$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $128.82 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $120.23 / $316.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $177.83 / $363.08
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $144.54 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $151.36 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $194.98
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $977.24 / $977.24
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $181.97
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $138.04
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $144.54 / $331.13