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Care Management Home Visit, New Patient, 45 Minutes

Kentucky 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 October 2026.

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

$100

Typical physician fee. In Kentucky, October 2026.

Insurers have agreed to pay about $100 for this service. Most negotiated rates run $75.86 to $115.

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.

How much rates vary

Facilitymedian $115 · 10th to 90th $112 to $166Professionalmedian $100 · 10th to 90th $76 to $135
$50$100$200$500facility $115professional $100

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
$112.20
Median
$114.82
Typical High
$125.89
Aetna
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$114.82
Typical High
$125.89
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$56.23
Median
$57.54
Typical High
$63.10
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$22.39
Median
$23.44
Typical High
$25.12
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$16.98
Median
$17.38
Typical High
$19.05
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$11.22
Median
$11.48
Typical High
$12.59
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$114.82
Cigna
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$112.20
Typical High
$575.44
Molina
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
United
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$134.90
Typical High
$199.53

Where Kentucky 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.

Kentucky· 50th of 51

$100

AK $224AZ $100

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.