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Nursing Facility Evaluation for Acute Change in Condition

Maine 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.

Professionalmedian $195 · 10th–90th $178$2820%20%40%10th90th$195$200.0

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
Professional
Modifier
Global
Typical Low
$165.96
Median
$177.83
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$223.87
Typical High
$263.03
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$177.83
Typical High
$177.83
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$281.84
Typical High
$346.74