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Pennsylvania rates for HCPCS G9487

Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved CMS Innovation Center Demonstration Project, which requires at least two of the following three key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, 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 of low to moderate severity. Typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.07 / $29.31 / $29.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.76 / $29.31 / $34.77
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,459.92 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.43 / $37.81 / $67.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.40 / $42.40 / $42.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.84 / $31.84 / $31.84
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.53 / $77.53 / $77.53
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.61 / $52.34 / $73.22
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.07 / $29.31 / $29.31
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.76 / $29.91 / $36.50
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.50 / $86.70 / $86.70
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.40 / $42.40 / $42.40
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.84 / $31.84 / $31.84
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.94 / $35.94 / $40.92
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.52 / $36.47 / $36.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $41.49 / $69.81