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Extensive Care Management Home Visit, 75 Minutes

Texas 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?

$195

Typical negotiated rate. In Texas, October 2026.

Insurers have agreed to pay about $195 for this service. The price depends on where it is billed: about $195 from a physician practice, and about $174 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$195$155 to $219
FacilityA hospital or hospital-owned outpatient department$174$138 to $219

How much rates vary

Facilitymedian $174 · 10th to 90th $123 to $257Professionalmedian $195 · 10th to 90th $35 to $1,349
$50$100$200$500$1Kfacility $174professional $195

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
$123.03
Median
$123.03
Typical High
$173.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$154.88
Typical High
$204.17
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$61.66
Median
$77.62
Typical High
$102.33
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$24.55
Median
$30.90
Typical High
$40.74
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$18.62
Median
$22.91
Typical High
$30.20
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$12.30
Median
$15.49
Typical High
$20.42
BCBS Texas
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$741.31
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$1,348.96
Median
$1,819.70
Typical High
$1,819.70
Moda Health
Setting
Facility
Modifier
None
Typical Low
$123.03
Median
$186.21
Typical High
$251.19
Moda Health
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$154.88
Typical High
$204.17
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$61.66
Median
$77.62
Typical High
$100.00
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$24.55
Median
$30.90
Typical High
$39.81
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$18.62
Median
$22.91
Typical High
$30.20
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$12.30
Median
$15.49
Typical High
$19.95
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$194.98
Typical High
$218.78
Providence
Setting
Facility
Modifier
None
Typical Low
$123.03
Median
$213.80
Typical High
$288.40
Providence
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
United
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$229.09
Typical High
$338.84
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$218.78
Typical High
$218.78

Where Texas 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.

Texas· 46th of 51

$195

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.