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Nursing Facility Evaluation for Acute Change in Condition

Rhode Island 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 $427 · 10th–90th $372$5500%20%10th90th$427Professionalmedian $209 · 10th–90th $191$2570%50%10th90th$209$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$426.58
Typical High
$549.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$245.47
Typical High
$331.13