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South Dakota rates for HCPCS G9481

Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved CMS Innovation Center Demonstration Project, which requires these three key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. Counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

Facilitymedian $15 · 10th–90th $14–$220%20%40%10th90th$15Professionalmedian $16 · 10th–90th $13–$300%20%10th90th$16$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $19.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $19.05 / $23.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $16.22 / $35.48
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $29.51 / $114.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $29.51 / $29.51
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $24.55 / $34.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $32.36 / $45.71
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $25.70 / $25.70