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Nursing Facility Evaluation for Acute Change in Condition

Tennessee 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 $263 · 10th–90th $182$1,2020%20%10th90th$263Professionalmedian $182 · 10th–90th $151$1950%50%10th90th$182$200.0$500.0$1.0K

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
$151.36
Median
$181.97
Typical High
$263.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$181.97
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$257.04
Typical High
$416.87