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New York rates for HCPCS G0511

Rural Health Clinic or Federally Qualified Health Center (RHC or FQHC) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an RHC or FQHC practitioner (physician, NP, PA, or CNM), per calendar month

Facilitymedian $46 · 10th–90th $36–$910%20%10th90th$46Professionalmedian $72 · 10th–90th $43–$1320%10%20%10th90th$72$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $79.43 / $81.28
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $52.48 / $52.48
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $61.66 / $125.89
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $87.10 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $213.80 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $72.44 / $165.96
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $43.65 / $81.28
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $61.66 / $123.03