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Nursing Facility Evaluation for Acute Change in Condition

Colorado 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 $166 · 10th–90th $166$3160%50%90th$166Professionalmedian $166 · 10th–90th $158$2400%50%10th90th$166$100.0$200.0$500.0$1.0K

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
$165.96
Median
$165.96
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$208.93
Typical High
$302.00
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Select Health
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$165.96
Typical High
$331.13
Select Health
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$316.23
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$295.12
Typical High
$467.74