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Moderate Care Management Home Visit, 45 Minutes

Pennsylvania rates for HCPCS G0083

Moderate (45 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)

Rates data updated October 2026.

How much does Moderate Care Management Home Visit, 45 Minutes cost?

$123

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $123 for this service. The price depends on where it is billed: about $123 from a physician practice, and about $141 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$123$115 to $129
FacilityA hospital or hospital-owned outpatient department$141$141 to $5,012

How much rates vary

Facilitymedian $141 · 10th to 90th $120 to $5,012Professionalmedian $123 · 10th to 90th $115 to $141
$100$500$2K$10K$50Kfacility $141professional $123

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
$114.82
Median
$141.25
Typical High
$141.25
Aetna
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$114.82
Typical High
$141.25
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Geisinger
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$100.00
Typical High
$154.88
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$114.82
Typical High
$141.25
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$141.25
Typical High
$141.25
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$125.89
Typical High
$141.25
United
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$134.90
Typical High
$234.42

Where Pennsylvania sits

The same service costs 2.2 times more in Alaska than in Kentucky. 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.

Pennsylvania· 37th of 51

$123

AK $224KY $100

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.