go back

Limited Home Care Plan Oversight, 30 Minutes

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)

Rates data updated July 2026.

How much does Limited Home Care Plan Oversight, 30 Minutes cost?

$72.44

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $72.44 for this service. The price depends on where it is billed: about $72.44 from a physician practice, and about $85.11 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$72.44$66.07 to $79.43
FacilityA hospital or hospital-owned outpatient department$85.11$85.11 to $85.11

How much rates vary

Facilitymedian $85 · 10th to 90th $85 to $85Professionalmedian $72 · 10th to 90th $51 to $85
$100.0$1.0K$10.0Kfacility $85professional $72

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
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$72.44
Typical High
$85.11
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$75.86
Typical High
$131.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$58.88
Typical High
$93.33
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$74.13
Typical High
$85.11
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$83.18
Typical High
$83.18
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$83.18
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$89.13
Typical High
$141.25

Where Pennsylvania sits

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

Pennsylvania $72.44 · 40th of 51
ND $123LA $64.57

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.