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Pennsylvania rates for HCPCS G0180

Physician or allowed practitioner certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians or allowed practitioners to affirm the initial implementation of the plan of care

Facilitymedian $27 · 10th–90th $27–$500%20%40%90th$27Professionalmedian $52 · 10th–90th $46–$850%20%10th90th$52$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $52.48 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $120.23
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $54.95 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $60.26
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $81.28 / $93.33
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $120.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $53.70 / $77.62
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $50.12 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $50.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $54.95 / $97.72