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South Dakota 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.15 / $43.15 / $43.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.22 / $39.22 / $46.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.00 / $65.76 / $67.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.18 / $46.14 / $76.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.42 / $73.80 / $290.08
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.50 / $69.39 / $109.49
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.67 / $68.29 / $103.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.63 / $67.04 / $92.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.42 / $73.80 / $95.20
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.50 / $69.70 / $69.70