Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow
Medicare pricing data for 6,011 providers across 45 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 supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow (HCPCS code G0181) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $103.96, but hospitals typically charge $165.51 — a 1.6x 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 $103.96, your out-of-pocket cost would be approximately $20.79. 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 1.6x more than what Medicare allows for this procedure. Medicare actually pays $80.93 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $112 | $216 | 267 | 5,979 | +7.6% |
| California | $111 | $162 | 938 | 188,446 | +7.1% |
| District of Columbia | $110 | $238 | 13 | 41 | +6.3% |
| New Jersey | $109 | $267 | 210 | 3,370 | +5.0% |
| Connecticut | $109 | $208 | 28 | 2,197 | +4.6% |
| Hawaii | $108 | $269 | 3 | 51 | +3.6% |
| Illinois | $106 | $156 | 401 | 42,872 | +2.4% |
| Maine | $104 | $248 | 4 | 15 | +0.3% |
| Georgia | $104 | $175 | 67 | 2,846 | +0.1% |
| Rhode Island | $103 | $223 | 16 | 149 | -0.5% |
| Delaware | $103 | $174 | 13 | 157 | -1.3% |
| Massachusetts | $102 | $275 | 177 | 3,229 | -2.1% |
| Michigan | $101 | $174 | 252 | 5,497 | -3.1% |
| South Dakota | $100 | $102 | 1 | 62 | -3.4% |
| Nevada | $99 | $169 | 129 | 19,079 | -4.3% |
| West Virginia | $99 | $171 | 13 | 167 | -4.7% |
| Pennsylvania | $99 | $156 | 105 | 3,145 | -4.7% |
| Maryland | $99 | $143 | 110 | 1,624 | -5.2% |
| North Carolina | $98 | $200 | 61 | 847 | -5.5% |
| Wisconsin | $98 | $259 | 22 | 198 | -6.0% |
| Arkansas | $97 | $169 | 43 | 2,685 | -6.6% |
| Kentucky | $97 | $331 | 44 | 452 | -6.6% |
| Vermont | $96 | $170 | 7 | 75 | -7.3% |
| Oregon | $96 | $237 | 21 | 280 | -7.6% |
| New Mexico | $96 | $152 | 31 | 641 | -7.7% |
| Washington | $95 | $156 | 54 | 1,081 | -8.2% |
| Virginia | $95 | $171 | 94 | 1,201 | -8.3% |
| Florida | $95 | $165 | 652 | 23,101 | -8.4% |
| Louisiana | $95 | $166 | 119 | 3,654 | -8.9% |
| Alabama | $94 | $157 | 72 | 1,595 | -9.1% |
| Texas | $94 | $158 | 933 | 68,818 | -9.9% |
| Nebraska | $93 | $198 | 6 | 70 | -10.1% |
| Arizona | $93 | $180 | 186 | 8,882 | -10.2% |
| Kansas | $93 | $164 | 51 | 988 | -10.4% |
| Colorado | $93 | $150 | 37 | 529 | -10.4% |
| Missouri | $93 | $164 | 24 | 411 | -11.0% |
| Minnesota | $92 | $289 | 8 | 53 | -11.3% |
| Utah | $92 | $157 | 118 | 4,727 | -11.9% |
| Ohio | $91 | $157 | 91 | 2,634 | -12.2% |
| Tennessee | $91 | $200 | 101 | 2,504 | -12.6% |
| Oklahoma | $91 | $172 | 184 | 4,548 | -12.9% |
| South Carolina | $90 | $148 | 71 | 1,198 | -13.0% |
| Indiana | $90 | $178 | 89 | 4,223 | -13.1% |
| Idaho | $85 | $194 | 16 | 151 | -18.5% |
| Mississippi | $84 | $167 | 71 | 2,240 | -19.4% |
⚠️ 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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