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Pennsylvania rates for HCPCS G0086

Limited (30 minutes) care management home care plan oversight. 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)

Facilitymedian $83 · 10th–90th $83–$870%50%90th$83Professionalmedian $72 · 10th–90th $51–$890%50%10th90th$72$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $72.44 / $85.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $75.86 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $57.54 / $93.33
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $74.13 / $87.10
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $83.18 / $87.10
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $75.86 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $89.13 / $141.25