go back

Nursing Facility Evaluation for Acute Change in Condition

Montana 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 $324 · 10th–90th $316$3550%50%10th90th$324Professionalmedian $316 · 10th–90th $182$3550%20%40%10th90th$316$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
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$323.59
Typical High
$354.81
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$323.59
Typical High
$354.81
Providence
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$186.21
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$331.13
Typical High
$363.08