Remote In-Home Visit, Existing, 40 Minutes (BPCI Advanced)

North Carolina rates for HCPCS G9986

Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) model episode of care, which requires at least two of the following three key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. Counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

Rates data updated July 2026.

How much does Remote In-Home Visit, Existing, 40 Minutes (BPCI Advanced) cost?

$112

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $112 for this service. The price depends on where it is billed: about $110 from a physician practice, and about $117 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed by	Who charges it	Typical	Range
Physician practiceA doctor's office, clinic or independent provider	A doctor's office, clinic or independent provider	$110	$97.72 to $132
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$117	$102 to $141

How much rates vary

Facilitymedian $117 · 10th to 90th $93 to $174Professionalmedian $110 · 10th to 90th $93 to $182

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $117.49 Median $117.49 Typical High $186.21	Facility	Global	$117.49	$117.49	$186.21
Aetna Setting Professional Modifier Global Typical Low $91.20 Median $107.15 Typical High $120.23	Professional	Global	$91.20	$107.15	$120.23
BCBS Setting Professional Modifier Global Typical Low $97.72 Median $131.83 Typical High $275.42	Professional	Global	$97.72	$131.83	$275.42
Cigna Setting Professional Modifier Global Typical Low $154.88 Median $154.88 Typical High $154.88	Professional	Global	$154.88	$154.88	$154.88
Medcost Setting Facility Modifier Global Typical Low $93.33 Median $117.49 Typical High $162.18	Facility	Global	$93.33	$117.49	$162.18
United Setting Professional Modifier Global Typical Low $102.33 Median $128.82 Typical High $204.17	Professional	Global	$102.33	$128.82	$204.17
Wellcare Setting Facility Modifier Global Typical Low $758.58 Median $758.58 Typical High $758.58	Facility	Global	$758.58	$758.58	$758.58
Wellcare Setting Professional Modifier Global Typical Low $891.25 Median $1,318.26 Typical High $1,318.26	Professional	Global	$891.25	$1,318.26	$1,318.26

Where North Carolina sits

The same service costs 2.5 times more in North Dakota than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

North Carolina· 18th of 51

$112

ND $234DE $95.50

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.