Principal Care Management, Clinical Staff, 30 Minutes

Pennsylvania rates for HCPCS G2065

Comprehensive care management for a single high risk disease services, e.g., principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, 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 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 Principal Care Management, Clinical Staff, 30 Minutes cost?

$41.69

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $41.69 for this service. Most negotiated rates run $38.02 to $41.69.

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 $38 · 10th to 90th $38 to $43Professionalmedian $42 · 10th to 90th $32 to $44

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	Facility/Professional	Modifier	Typical Low	Median	Typical High
Geisinger Setting Professional Modifier Global Typical Low $30.90 Median $41.69 Typical High $44.67	Professional	Global	$30.90	$41.69	$44.67
UPMC Health Plan Setting Facility Modifier Global Typical Low $38.02 Median $38.02 Typical High $42.66	Facility	Global	$38.02	$38.02	$42.66
UPMC Health Plan Setting Professional Modifier Global Typical Low $37.15 Median $38.02 Typical High $42.66	Professional	Global	$37.15	$38.02	$42.66
United Setting Professional Modifier Global Typical Low $38.02 Median $38.02 Typical High $38.02	Professional	Global	$38.02	$38.02	$38.02

Where Pennsylvania sits

The same service costs 3.3 times more in Massachusetts than in South Carolina. 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· 21st of 36

$41.69

MA $100SC $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.