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New York 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 $126 · 10th–90th $78–$2040%20%40%10th90th$126Professionalmedian $123 · 10th–90th $91–$1620%20%10th90th$123$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$77.62 / $123.03 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $114.82 / $144.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $138.04 / $213.80
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $162.18
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $204.17 / $489.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $199.53 / $263.03
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $114.82 / $114.82
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $213.80
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $169.82 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $416.87 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $147.91 / $295.12
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $114.82 / $131.83
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $208.93