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Michigan rates for HCPCS G2004

Comprehensive (60 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 $166 · 10th–90th $166–$4570%50%90th$166Professionalmedian $155 · 10th–90th $132–$2190%10%20%10th90th$155$200.0$500.0

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
$165.96 / $165.96 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $147.91 / $186.21
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $263.03
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $457.09 / $537.03
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $173.78 / $234.42
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $204.17 / $251.19