go back

Care Management Home Visit, New Patient, 75 Minutes

Illinois rates for HCPCS G0080

Extensive (75 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, 75 Minutes cost?

$209

Typical physician fee. In Illinois, October 2026.

Insurers have agreed to pay about $209 for this service. Most negotiated rates run $209 to $209.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $209 · 10th to 90th $100 to $214Professionalmedian $209 · 10th to 90th $191 to $240
$100$200facility $209professional $209

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
$208.93
Median
$208.93
Typical High
$213.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$208.93
Typical High
$208.93
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$95.50
Median
$104.71
Typical High
$104.71
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$38.90
Median
$41.69
Typical High
$41.69
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$28.84
Median
$31.62
Typical High
$31.62
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$19.50
Median
$20.89
Typical High
$20.89
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$323.59
Hally Health
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$208.93
Typical High
$380.19
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$257.04
Typical High
$275.42
Molina
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
United
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$257.04
Typical High
$407.38

Where Illinois 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.

Illinois· 39th of 51

$209

AK $380AZ $170

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.