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Nursing Facility Evaluation for Acute Change in Condition

Nationwide rates for HCPCS G9685

Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. This service is for a demonstration project

Rates data updated July 2026.

Facilitymedian $219 · 10th–90th $155$7590%20%40%10th90th$219Professionalmedian $178 · 10th–90th $145$3550%50%10th90th$178$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$169.82
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$165.96
Typical High
$208.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$112.20
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$616.60
Typical High
$1,819.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$199.53
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$316.23
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$257.04
Typical High
$436.52