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Ohio 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 $43 · 10th–90th $38–$660%20%10th90th$43$10.0$20.0$50.0$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
$38.90 / $42.66 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $58.88 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $45.71 / $74.13