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Pennsylvania 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 $95 · 10th–90th $95–$1450%50%90th$95Professionalmedian $107 · 10th–90th $93–$1320%20%40%10th90th$107$50.0$200.0$1.0K$5.0K$20.0K

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
$95.50 / $95.50 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $102.33 / $131.83
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $93.33 / $123.03
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $104.71 / $131.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $120.23 / $144.54
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $117.49 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $147.91 / $234.42