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Home Visit for Patient Assessment (BPCI Initiative)

Texas 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?

$42.66

Typical negotiated rate. In Texas, October 2026.

Insurers have agreed to pay about $42.66 for this service. The price depends on where it is billed: about $39.81 from a physician practice, and about $48.98 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$39.81$33.11 to $46.77
FacilityA hospital or hospital-owned outpatient department$48.98$38.02 to $51.29

How much rates vary

Facilitymedian $49 · 10th to 90th $28 to $56Professionalmedian $40 · 10th to 90th $26 to $51
$10$20$50$100facility $49professional $40

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$26.30
Median
$26.30
Typical High
$38.02
Aetna
Setting
Professional
Modifier
None
Typical Low
$26.30
Median
$33.11
Typical High
$41.69
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$13.18
Median
$16.60
Typical High
$20.89
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$5.25
Median
$6.61
Typical High
$8.32
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$3.98
Median
$4.90
Typical High
$6.31
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$2.63
Median
$3.31
Typical High
$4.17
Christus
Setting
Facility
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Cigna
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Moda Health
Setting
Facility
Modifier
None
Typical Low
$30.90
Median
$48.98
Typical High
$53.70
Moda Health
Setting
Professional
Modifier
None
Typical Low
$26.30
Median
$33.11
Typical High
$43.65
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$13.18
Median
$16.60
Typical High
$20.89
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$5.25
Median
$6.61
Typical High
$8.32
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$3.98
Median
$5.01
Typical High
$6.31
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$2.63
Median
$3.31
Typical High
$4.17
Molina
Setting
Professional
Modifier
None
Typical Low
$6.92
Median
$33.11
Typical High
$39.81
Providence
Setting
Facility
Modifier
None
Typical Low
$32.36
Median
$48.98
Typical High
$60.26
Providence
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
United
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$41.69
Typical High
$64.57
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29

Where Texas 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.

Texas· 44th of 51

$42.66

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.