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Care Management Home Visit, New Patient, 45 Minutes

Virginia 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 July 2026.

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

$126

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $123 from a physician practice, and about $145 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$123$112 to $141
FacilityA hospital or hospital-owned outpatient department$145$123 to $166

How much rates vary

Facilitymedian $145 · 10th to 90th $107 to $269Professionalmedian $123 · 10th to 90th $95 to $162
$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0Kfacility $145professional $123

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$144.54
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$123.03
Typical High
$144.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$117.49
Typical High
$154.88
Medcost
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$128.82
Typical High
$173.78
Sentara
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$158.49
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$158.49
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$158.49
Typical High
$269.15

Where Virginia sits

The same service costs 1.8 times more in North Dakota than in Louisiana. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Virginia $126 · 11th of 51
ND $204LA $112

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.