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Care Management Home Visit, New Patient, 45 Minutes

Illinois 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)

Rates data updated July 2026.

How much does Care Management Home Visit, New Patient, 45 Minutes cost?

$120

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $120 for this service. The price depends on where it is billed: about $120 from a physician practice, and about $120 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 5 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$120$112 to $129
FacilityA hospital or hospital-owned outpatient department$120$120 to $120

How much rates vary

Facilitymedian $120 · 10th to 90th $120 to $120Professionalmedian $120 · 10th to 90th $98 to $145
$50.0$100.0$200.0$500.0facility $120professional $120

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
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$120.23
Typical High
$144.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$165.96
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$114.82
Typical High
$162.18
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$151.36
Typical High
$158.49
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$208.93
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$165.96
Typical High
$239.88

Where Illinois sits

The same service costs 1.8 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.

Illinois $120 · 37th of 51
ND $204LA $112

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.