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Extensive Care Management Home Visit, 75 Minutes

South Carolina 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?

$214

Typical physician fee. In South Carolina, October 2026.

Insurers have agreed to pay about $214 for this service. Most negotiated rates run $214 to $275.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $224 · 10th to 90th $214 to $575Professionalmedian $214 · 10th to 90th $200 to $372
$200$500facility $224professional $214

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
$213.80
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$104.71
Median
$107.15
Typical High
$107.15
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$31.62
Median
$32.36
Typical High
$32.36
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$21.38
Median
$21.38
Typical High
$21.38
BCBS South Carolina
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$251.19
Typical High
$257.04
BCBS South Carolina
Setting
Professional
Modifier
29
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Medcost
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$234.42
Typical High
$575.44
Medcost
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Molina
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$275.42
Typical High
$389.05
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$234.42
Typical High
$331.13

Where South Carolina 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.

South Carolina· 29th of 51

$214

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.