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Nursing Facility Evaluation for Acute Change in Condition

Kentucky 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 $162 · 10th–90th $162$2190%50%90th$162Professionalmedian $162 · 10th–90th $145$2290%20%40%10th90th$162$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
$162.18
Median
$162.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$162.18
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$758.58
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$229.09
Typical High
$309.03