go back

New York rates for HCPCS G2025

Payment for a telehealth distant site service furnished by a Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC) only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.03 / $94.17 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.03 / $92.03 / $103.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.95 / $87.79 / $163.04
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.75 / $75.75 / $75.75
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.75 / $75.75 / $75.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.16 / $109.16 / $109.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.90 / $86.90 / $86.90
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.66 / $246.04 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.01 / $133.41 / $198.14
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.31 / $91.31 / $108.66
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.59 / $106.83 / $223.66
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.38 / $69.38 / $69.38
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.16 / $109.16 / $195.27
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.56 / $86.90 / $181.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.45 / $98.07 / $199.06
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.31 / $105.08 / $108.66
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.16 / $106.83 / $224.90