go back

Nursing Facility Evaluation for Acute Change in Condition

Ohio 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 $170 · 10th–90th $145$2000%20%10th90th$170Professionalmedian $145 · 10th–90th $145$1780%50%90th$145$2.0$10.0$50.0$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
Facility
Modifier
Global
Typical Low
$144.54
Median
$169.82
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$162.18
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
$144.54
Typical High
$144.54
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$208.93
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$316.23
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$245.47
Typical High
$346.74