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Pennsylvania 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)

Professionalmedian $209 · 10th–90th $148–$2510%20%10th90th$209$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $245.47
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $213.80 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $169.82 / $263.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $251.19
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $407.38