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Extensive Care Management Home Visit, 75 Minutes

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)

Rates data updated July 2026.

How much does Extensive Care Management Home Visit, 75 Minutes cost?

$209

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $209 for this service. Most negotiated rates run $191 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 9 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $209 · 10th to 90th $148 to $245
$200.0$500.0$1.0Kprofessional $209

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$208.93
Typical High
$245.47
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$213.80
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$173.78
Typical High
$263.03
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$208.93
Typical High
$245.47
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$204.17
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$257.04
Typical High
$416.87

Where Pennsylvania sits

The same service costs 1.9 times more in North Dakota than in New Mexico. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $209 · 25th of 51
ND $355NM $186

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.