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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

Professionalmedian $44 · 10th–90th $27–$760%10%10th90th$44$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $37.15 / $48.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $44.67 / $114.82
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $53.70
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $44.67 / $54.95
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $42.66 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $61.66 / $95.50
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $42.66 / $51.29