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Home Visit for Patient Assessment (BPCI Initiative)

New York 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 July 2026.

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

$38.02

Typical physician fee. In New York, July 2026.

Insurers have agreed to pay about $38.02 for this service. Most negotiated rates run $34.67 to $50.12.

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 9 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $38 · 10th to 90th $28 to $81
$20$50$100professional $38

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$35.48
Typical High
$48.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$44.67
Typical High
$114.82
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$53.70
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$38.90
Typical High
$54.95
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$42.66
Typical High
$58.88
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$81.28
United
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$60.26
Typical High
$95.50
Univera
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$42.66
Typical High
$51.29

Where New York sits

The same service costs 2.5 times more in Montana 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 York· 49th of 51

$38.02

MT $79.43LA $32.36

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.