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Nursing Facility Evaluation for Acute Change in Condition

New Hampshire 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 $219 · 10th–90th $155$2630%50%10th90th$219Professionalmedian $219 · 10th–90th $186$3310%20%40%10th90th$219$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
$218.78
Typical High
$263.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$218.78
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$309.03
Typical High
$549.54
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$323.59
Typical High
$562.34