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Pennsylvania 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 $59 · 10th–90th $51–$600%50%10th90th$59Professionalmedian $48 · 10th–90th $36–$620%20%40%10th90th$48$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$58.88 / $58.88 / $58.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $47.86 / $60.26
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $50.12 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $38.90 / $66.07
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $50.12 / $61.66
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $51.29 / $60.26
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $48.98 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $63.10 / $102.33