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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 July 2026.

How much does Care Management Home Visit, New Patient, 60 Minutes cost?

$162

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $162 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $195 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 9 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$162$151 to $178
FacilityA hospital or hospital-owned outpatient department$195$195 to $195

How much rates vary

Facilitymedian $195 · 10th to 90th $195 to $200Professionalmedian $162 · 10th to 90th $120 to $200
$100.0$500.0$2.0K$10.0K$50.0Kfacility $195professional $162

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
$194.98
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$162.18
Typical High
$199.53
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$165.96
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$128.82
Typical High
$218.78
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$165.96
Typical High
$199.53
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$199.53
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$158.49
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$208.93
Typical High
$338.84

Where Pennsylvania 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.

Pennsylvania $162 · 36th of 51
ND $269LA $148

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.