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Ohio 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

Facilitymedian $129 · 10th–90th $129–$1290%50%$129Professionalmedian $141 · 10th–90th $110–$1410%50%10th$141$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $26.92
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $50.12 / $60.26
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80