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Home Visit for Patient Assessment (BPCI Initiative)

Illinois rates for HCPCS G9187

Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the Medicare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code

Rates data updated October 2026.

How much does Home Visit for Patient Assessment (BPCI Initiative) cost?

$46.77

Typical physician fee. In Illinois, October 2026.

Insurers have agreed to pay about $46.77 for this service. Most negotiated rates run $42.66 to $52.48.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $47 · 10th to 90th $43 to $100Professionalmedian $47 · 10th to 90th $38 to $68
$50$100facility $47professional $47

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$42.66
Median
$46.77
Typical High
$47.86
Aetna
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$46.77
Typical High
$47.86
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$19.05
Median
$22.91
Typical High
$23.99
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$7.59
Median
$9.33
Typical High
$9.55
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$5.75
Median
$6.92
Typical High
$7.24
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$3.80
Median
$4.68
Typical High
$4.79
Cigna
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$46.77
Typical High
$67.61
Hally Health
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$43.65
Typical High
$64.57
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$39.81
Typical High
$43.65
United
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$52.48
Typical High
$77.62

Where Illinois sits

The same service costs 4.9 times more in Alabama than in Louisiana. 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.

Illinois· 36th of 51

$46.77

AL $151LA $30.90

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.