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Pennsylvania rates for HCPCS G2005

Extensive (75 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.)

Professionalmedian $182 · 10th–90th $162–$2290%20%10th90th$182$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
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $177.83 / $223.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $213.80 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $169.82 / $223.87
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $181.97 / $229.09
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $309.03 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $257.04 / $398.11