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Nursing Facility Evaluation for Acute Change in Condition

Indiana 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 $135 · 10th–90th $135$1740%50%90th$135Professionalmedian $141 · 10th–90th $135$2000%20%40%10th90th$141$50.0$100.0$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
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$144.54
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$223.87
Typical High
$302.00