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Care Management Home Visit, New Patient, 45 Minutes

Texas 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 Texas, 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 $100 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$89.13 to $138
FacilityA hospital or hospital-owned outpatient department$100$79.43 to $126

How much rates vary

Facilitymedian $100 · 10th to 90th $71 to $145Professionalmedian $120 · 10th to 90th $23 to $776
$20$50$100$200$500$1Kfacility $100professional $120

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
$70.79
Median
$70.79
Typical High
$100.00
Aetna
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$89.13
Typical High
$117.49
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$35.48
Median
$44.67
Typical High
$58.88
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$14.13
Median
$17.78
Typical High
$23.44
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$10.47
Median
$13.18
Typical High
$17.38
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$7.08
Median
$8.91
Typical High
$11.75
Cigna
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$776.25
Median
$1,000.00
Typical High
$1,000.00
Moda Health
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$107.15
Typical High
$141.25
Moda Health
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$89.13
Typical High
$117.49
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$35.48
Median
$44.67
Typical High
$57.54
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$14.13
Median
$17.78
Typical High
$23.44
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$10.47
Median
$13.18
Typical High
$17.38
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$7.08
Median
$8.91
Typical High
$11.75
Molina
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$128.82
Typical High
$144.54
Providence
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$117.49
Typical High
$165.96
Providence
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
United
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$134.90
Typical High
$194.98
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23

Where Texas 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.

Texas· 37th 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.