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Home Visit for Patient Assessment (BPCI Initiative)

New Jersey 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?

$48.98

Typical physician fee. In New Jersey, October 2026.

Insurers have agreed to pay about $48.98 for this service. Most negotiated rates run $46.77 to $51.29.

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 $49 · 10th to 90th $49 to $54Professionalmedian $49 · 10th to 90th $44 to $59
$50$100facility $49professional $49

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
$48.98
Median
$48.98
Typical High
$53.70
Aetna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$53.70
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$24.55
Median
$24.55
Typical High
$26.92
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$9.77
Median
$9.77
Typical High
$10.72
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$7.24
Median
$7.41
Typical High
$8.13
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$4.90
Median
$4.90
Typical High
$5.37
Cigna
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$46.77
Typical High
$53.70
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$67.61
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$43.65
Median
$48.98
Typical High
$51.29
United
Setting
Professional
Modifier
None
Typical Low
$31.62
Median
$58.88
Typical High
$93.33

Where New Jersey 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.

New Jersey· 28th of 51

$48.98

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.