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Montana 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.)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.56 / $153.90 / $224.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$249.23 / $249.23 / $249.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.50 / $249.23 / $249.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.22 / $166.05 / $249.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.53 / $238.32 / $280.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.41 / $298.70 / $371.72