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Pennsylvania rates for HCPCS G0181

Physician or allowed practitioner supervision of a patient receiving Medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans

Facilitymedian $55 · 10th–90th $55–$1000%20%40%90th$55Professionalmedian $100 · 10th–90th $91–$1410%20%10th90th$100$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
$91.20 / $100.00 / $128.82
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $109.65 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $117.49
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $158.49 / $181.97
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $100.00 / $141.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $194.98