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Care Management Home Visit, New Patient, 45 Minutes

Massachusetts 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?

$120

Typical negotiated rate. In Massachusetts, October 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 $123 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$120$110 to $145
FacilityA hospital or hospital-owned outpatient department$123$123 to $166

How much rates vary

Facilitymedian $123 · 10th to 90th $115 to $195Professionalmedian $120 · 10th to 90th $110 to $407
$100$200$500$1K$2K$5Kfacility $123professional $120

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$18.20
Median
$18.20
Typical High
$18.20
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$114.82
AllWays Health Partners
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$776.25
Typical High
$776.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$154.88
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$123.03
Median
$123.03
Typical High
$194.98
Fallon Health
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$173.78
Typical High
$234.42
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$109.65
Typical High
$204.17
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$114.82
Mass General Brigham
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$776.25
Typical High
$776.25
United
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$181.97
Typical High
$398.11
Well Sense
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$131.83
Typical High
$204.17
Well Sense
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$97.72
Typical High
$131.83

Where Massachusetts 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.

Massachusetts· 36th of 51

$120

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.