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Pennsylvania rates for HCPCS G2064

Comprehensive care management services for a single high risk disease, e.g., principal care management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization, the condition requires development or revision of disease specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities

Rates data updated July 2026.

How much does HCPCS G2064 cost?

$89.13

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $89.13 for this service. Most negotiated rates run $83.18 to $95.50.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $85 · 10th to 90th $74 to $98Professionalmedian $93 · 10th to 90th $74 to $102
$100facility $85professional $93

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$102.33
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$85.11
Typical High
$97.72
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$97.72
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10

Where Pennsylvania sits

The same service costs 4.5 times more in Wisconsin than in Idaho. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 32nd of 39

$89.13

WI $135ID $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.