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Extensive Care Management Home Visit, 75 Minutes

Ohio rates for HCPCS G0085

Extensive (75 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 Extensive Care Management Home Visit, 75 Minutes cost?

$200

Typical physician fee. In Ohio, October 2026.

Insurers have agreed to pay about $200 for this service. Most negotiated rates run $162 to $219.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $200 · 10th to 90th $200 to $468Professionalmedian $200 · 10th to 90th $158 to $275
$200$500facility $200professional $200

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
$199.53
Median
$199.53
Typical High
$467.74
Aetna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$218.78
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$100.00
Median
$100.00
Typical High
$109.65
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$39.81
Median
$39.81
Typical High
$43.65
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$30.20
Median
$30.20
Typical High
$33.11
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$19.95
Median
$19.95
Typical High
$21.88
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$234.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Medical Mutual of Ohio
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Molina
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$194.98
Typical High
$281.84
SummaCare
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$208.93
Typical High
$223.87
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$239.88
Typical High
$389.05

Where Ohio sits

The same service costs 2.2 times more in North Dakota 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.

Ohio· 45th of 51

$200

ND $380KY $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.