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New York 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 $52 · 10th–90th $32–$830%20%40%10th90th$52Professionalmedian $52 · 10th–90th $39–$710%20%10th90th$52$1.0$10.0$100.0$1.0K$10.0K

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
$32.36 / $52.48 / $56.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $47.86 / $60.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $57.54 / $91.20
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $67.61
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $83.18 / $204.17
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $81.28 / $107.15
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $45.71 / $45.71
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $85.11
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $72.44 / $81.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $177.83 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $63.10 / $134.90
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $52.48
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $83.18