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Nursing Facility Evaluation for Acute Change in Condition

Georgia 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 $155 · 10th–90th $155$1550%50%$155Professionalmedian $158 · 10th–90th $155$2090%50%10th90th$158$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$158.49
Typical High
$169.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$173.78
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$263.03
Typical High
$436.52