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California rates for HCPCS G0081

Brief (20 minutes) care management home visit for an existing 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)

Facilitymedian $72 · 10th–90th $58–$1820%10%20%10th90th$72Professionalmedian $52 · 10th–90th $40–$1580%10%20%10th90th$52$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $54.95 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $47.86 / $128.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $72.44 / $181.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $208.93
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $61.66 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $63.10 / $77.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $81.28
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $389.05 / $389.05
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $54.95 / $75.86
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $79.43
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $61.66 / $138.04