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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.

Professionalmedian $38 · 10th–90th $28$810%20%10th90th$38$1.0$5.0$20.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

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