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Massachusetts rates for HCPCS G0469

Federally Qualified Health Center (FQHC) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving a mental health visit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.15 / $110.15 / $110.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.15 / $130.51 / $142.26
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.00 / $43.00 / $43.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $66.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.00 / $216.00 / $216.00
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00