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Care Management Home Visit, New Patient, 60 Minutes

Pennsylvania rates for HCPCS G0079

Comprehensive (60 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, 60 Minutes cost?

$158

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $200 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$158$158 to $174
FacilityA hospital or hospital-owned outpatient department$200$195 to $5,012

How much rates vary

Facilitymedian $200 · 10th to 90th $158 to $5,012Professionalmedian $158 · 10th to 90th $158 to $195
$200$1K$5K$20Kfacility $200professional $158

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
$158.49
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$194.98
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$79.43
Median
$79.43
Typical High
$97.72
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$31.62
Median
$31.62
Typical High
$38.90
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$23.99
Median
$23.99
Typical High
$29.51
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$15.85
Median
$15.85
Typical High
$19.50
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Geisinger
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$128.82
Typical High
$218.78
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$194.98
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$79.43
Median
$79.43
Typical High
$97.72
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$31.62
Median
$31.62
Typical High
$38.90
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$23.99
Median
$23.99
Typical High
$29.51
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$15.85
Median
$15.85
Typical High
$19.50
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$199.53
Typical High
$199.53
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$162.18
Typical High
$199.53
United
Setting
Professional
Modifier
None
Typical Low
$154.88
Median
$190.55
Typical High
$331.13

Where Pennsylvania sits

The same service costs 2.3 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.

Pennsylvania· 42nd of 51

$158

AK $302AZ $132

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.