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Texas rates for HCPCS G0501

Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.07 / $18.07 / $18.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.07 / $18.07 / $18.07
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.07 / $18.07 / $25.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.07 / $18.07 / $24.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,800,000.00 / $1,800,000.00 / $2,400,000.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $27.00