Physician or allowed practitioner 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 and
Medicare pricing data for 75,609 providers across 52 states
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 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 and (HCPCS code G0180) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $51.32, but hospitals typically charge $126.35 — a 2.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $51.32, your out-of-pocket cost would be approximately $10.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $39.49 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $60 | $188 | 19 | 175 | +17.1% |
| District of Columbia | $57 | $177 | 112 | 801 | +12.0% |
| California | $57 | $120 | 3,663 | 123,432 | +11.1% |
| New Jersey | $57 | $133 | 1,591 | 17,053 | +10.4% |
| New York | $57 | $167 | 3,426 | 34,791 | +10.3% |
| Hawaii | $55 | $166 | 13 | 100 | +7.5% |
| Massachusetts | $55 | $168 | 2,438 | 36,113 | +6.3% |
| Connecticut | $55 | $148 | 1,373 | 16,006 | +6.3% |
| Maryland | $54 | $135 | 1,529 | 16,501 | +5.5% |
| Rhode Island | $53 | $143 | 171 | 1,841 | +3.6% |
| Illinois | $53 | $133 | 2,985 | 52,205 | +3.5% |
| Washington | $52 | $152 | 1,472 | 13,613 | +1.3% |
| New Hampshire | $52 | $206 | 511 | 4,871 | +1.1% |
| Colorado | $52 | $118 | 793 | 7,156 | +0.6% |
| Delaware | $51 | $114 | 276 | 3,044 | +0.1% |
| Puerto Rico | $51 | $94 | 30 | 70 | -0.9% |
| Wyoming | $51 | $166 | 20 | 197 | -0.9% |
| Virginia | $51 | $113 | 2,470 | 23,362 | -1.1% |
| Pennsylvania | $51 | $130 | 4,349 | 34,119 | -1.1% |
| Montana | $51 | $114 | 87 | 613 | -1.2% |
| Florida | $50 | $115 | 6,982 | 135,573 | -2.0% |
| Maine | $50 | $142 | 232 | 1,915 | -2.1% |
| South Dakota | $50 | $136 | 222 | 1,302 | -2.5% |
| Michigan | $50 | $115 | 3,366 | 28,990 | -2.6% |
| North Dakota | $50 | $155 | 310 | 1,618 | -2.8% |
| Missouri | $50 | $116 | 1,002 | 7,711 | -2.9% |
| Texas | $50 | $116 | 5,023 | 66,363 | -3.0% |
| Georgia | $50 | $128 | 1,439 | 18,195 | -3.3% |
| Vermont | $50 | $135 | 282 | 2,347 | -3.5% |
| Oregon | $49 | $144 | 428 | 2,688 | -3.6% |
| Minnesota | $49 | $158 | 2,274 | 14,450 | -3.7% |
| Nevada | $49 | $102 | 313 | 10,131 | -4.0% |
| Arizona | $49 | $106 | 871 | 13,207 | -4.9% |
| Wisconsin | $49 | $219 | 1,655 | 10,220 | -5.4% |
| Ohio | $48 | $129 | 4,280 | 34,255 | -5.6% |
| Nebraska | $48 | $106 | 252 | 2,157 | -6.1% |
| New Mexico | $48 | $118 | 305 | 1,921 | -6.1% |
| South Carolina | $48 | $127 | 2,155 | 18,904 | -6.2% |
| Louisiana | $48 | $126 | 2,283 | 19,408 | -6.3% |
| Utah | $48 | $108 | 463 | 5,111 | -6.6% |
| North Carolina | $48 | $131 | 2,887 | 25,683 | -6.7% |
| West Virginia | $48 | $113 | 312 | 2,935 | -7.2% |
| Indiana | $48 | $107 | 1,342 | 11,413 | -7.3% |
| Alabama | $48 | $93 | 1,500 | 18,586 | -7.3% |
| Oklahoma | $47 | $109 | 1,482 | 16,298 | -7.6% |
| Kentucky | $47 | $113 | 1,274 | 11,871 | -7.6% |
| Tennessee | $47 | $116 | 2,092 | 25,098 | -8.0% |
| Iowa | $47 | $133 | 659 | 3,881 | -8.1% |
| Idaho | $47 | $116 | 406 | 2,772 | -8.3% |
| Kansas | $47 | $125 | 440 | 5,564 | -8.3% |
| Arkansas | $47 | $104 | 667 | 7,433 | -9.0% |
| Mississippi | $46 | $103 | 1,059 | 13,666 | -10.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber