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Nursing Facility Evaluation for Acute Change in Condition

Washington, DC 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 $174 · 10th–90th $174$1740%50%100%$174Professionalmedian $174 · 10th–90th $174$3310%50%90th$174$200.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$331.13
Typical High
$446.68