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Physician Documentation of DME Face-to-Face Visit

Massachusetts rates for HCPCS G0454

Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist

Rates data updated July 2026.

How much does Physician Documentation of DME Face-to-Face Visit cost?

$10.96

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $10.96 for this service. The price depends on where it is billed: about $10.96 from a physician practice, and about $9.55 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 7 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$10.96$8.51 to $17.38
FacilityA hospital or hospital-owned outpatient department$9.55$8.32 to $11.48

How much rates vary

Facilitymedian $10 · 10th to 90th $8 to $19Professionalmedian $11 · 10th to 90th $7 to $23
$10$20$50facility $10professional $11

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
$8.32
Median
$8.32
Typical High
$8.32
Aetna
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$8.32
Typical High
$10.96
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$12.02
Typical High
$54.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$8.32
Median
$8.32
Typical High
$8.32
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$7.59
Median
$10.00
Typical High
$15.85
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$10.72
Typical High
$15.85
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$15.14
Typical High
$23.44
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$12.02
Typical High
$54.95
United
Setting
Facility
Modifier
Global
Typical Low
$8.71
Median
$8.71
Typical High
$8.71
United
Setting
Professional
Modifier
Global
Typical Low
$8.91
Median
$14.79
Typical High
$23.99

Where Massachusetts sits

The same service costs 2.0 times more in Minnesota than in Louisiana. 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.

Massachusetts· 8th of 51

$10.96

MN $15.85LA $7.94

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.