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Care Management Home Visit, New Patient, 45 Minutes

North Carolina 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?

$123

Typical physician fee. In North Carolina, October 2026.

Insurers have agreed to pay about $123 for this service. Most negotiated rates run $117 to $170.

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 $123 · 10th to 90th $123 to $123Professionalmedian $123 · 10th to 90th $117 to $257
$100$200facility $123professional $123

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
$123.03
Median
$123.03
Typical High
$123.03
Aetna
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
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
$24.55
Median
$24.55
Typical High
$24.55
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
$12.30
Median
$12.30
Typical High
$12.30
BCBS North Carolina
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$117.49
Typical High
$263.03
Cigna
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Medcost
Setting
Facility
Modifier
None
Typical Low
$123.03
Median
$123.03
Typical High
$138.04
United
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$151.36
Typical High
$245.47

Where North Carolina 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.

North Carolina· 31st of 51

$123

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.