G0179

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a

Medicare pricing data for 45,467 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a (HCPCS code G0179) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $40.12, but hospitals typically charge $89.97 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.02

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $40.12, your out-of-pocket cost would be approximately $8.02. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$40.12
Average Hospital Charge
$89.97
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$89.97
Medicare Allowed$40.12
Medicare Payment$30.17

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $30.17 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$46$11749332+15.5%
New York$46$1122,05322,280+14.9%
Hawaii$46$1088108+14.5%
Alaska$46$13819182+14.2%
New Jersey$45$926154,392+12.5%
California$44$872,32784,939+9.5%
Connecticut$44$1159279,558+9.0%
Massachusetts$44$1291,68114,766+8.9%
Washington$43$988185,310+6.0%
Illinois$43$881,77530,171+6.0%
Rhode Island$42$114107522+5.5%
Maryland$42$975134,351+5.1%
Montana$41$9238120+2.8%
New Hampshire$41$1553151,618+2.8%
Colorado$41$934094,058+2.3%
Delaware$41$952001,361+1.4%
Wyoming$41$10514152+1.1%
Pennsylvania$40$981,9448,804-0.4%
Oregon$40$1102061,086-0.7%
Virginia$40$821,1398,453-0.9%
Puerto Rico$40$461026-1.0%
South Dakota$40$105100712-1.2%
Florida$40$833,91856,528-1.4%
Maine$39$116149527-1.7%
Missouri$39$883541,417-1.8%
North Dakota$39$133132637-1.8%
Minnesota$39$1341,4777,790-2.0%
Texas$39$834,177106,892-2.2%
Michigan$39$811,3638,349-2.2%
Georgia$39$10299910,711-2.2%
Nevada$39$791938,962-2.2%
Vermont$39$952071,259-2.4%
Wisconsin$39$1537443,406-3.0%
Arizona$39$855224,221-3.9%
South Carolina$38$949767,737-4.9%
Ohio$38$952,68425,041-5.5%
Louisiana$38$891,67822,584-5.6%
Utah$38$853223,322-5.7%
New Mexico$38$871561,197-5.9%
Nebraska$38$95157852-6.0%
Indiana$38$858097,474-6.3%
North Carolina$38$981,96114,901-6.4%
Alabama$37$731,19315,260-6.7%
Iowa$37$963792,116-6.7%
West Virginia$37$912221,819-7.3%
Tennessee$37$851,53820,712-7.4%
Kansas$37$793133,259-7.6%
Kentucky$37$818096,307-7.6%
Oklahoma$37$801,16126,090-7.9%
Idaho$37$792371,458-8.0%
Arkansas$37$864575,028-8.4%
Mississippi$36$8288216,562-10.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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