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Home Visit for Patient Assessment (BPCI Advanced)

Washington, DC rates for HCPCS G9987

Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a BPCI Advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code

Rates data updated October 2026.

How much does Home Visit for Patient Assessment (BPCI Advanced) cost?

$46.77

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $46.77 for this service. Most negotiated rates run $46.77 to $46.77.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $47 · 10th to 90th $47 to $47Professionalmedian $47 · 10th to 90th $43 to $47
$50$100facility $47professional $47

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Aetna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$46.77
Typical High
$46.77
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$21.38
Median
$23.44
Typical High
$23.44
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$8.51
Median
$9.33
Typical High
$9.33
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$6.46
Median
$7.08
Typical High
$7.08
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$4.27
Median
$4.68
Typical High
$4.68
Cigna
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$46.77
Typical High
$54.95
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$44.67
Typical High
$114.82
United
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$53.70
Typical High
$123.03

Where Washington, DC sits

The same service costs 2.6 times more in North Dakota than in Ohio. 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.

Washington, DC· 19th of 51

$46.77

ND $89.13OH $33.88

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.