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California rates for HCPCS G2003

Moderate (45 minutes) in-home visit for a new patient postdischarge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than nine times.)

Facilitymedian $155 · 10th–90th $123$3890%10%20%10th90th$155Professionalmedian $117 · 10th–90th $95$2340%10%20%10th90th$117$50.0$100.0$200.0$500.0$1.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $109.65 / $138.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $154.88 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $389.05
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $147.91 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $151.36 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $194.98
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $977.24 / $977.24
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $181.97
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $138.04
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $144.54 / $331.13