G0406

Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth

Medicare pricing data for 519 providers across 37 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth (HCPCS code G0406) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $39.80, but hospitals typically charge $101.85 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.96

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $39.80, your out-of-pocket cost would be approximately $7.96. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$39.80
Average Hospital Charge
$101.85
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$101.85
Medicare Allowed$39.80
Medicare Payment$31.03

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $31.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Washington$45$1201070+13.1%
New Jersey$44$97926+10.0%
Illinois$43$18117456+8.9%
California$43$8132671+8.6%
Pennsylvania$43$10723438+8.1%
West Virginia$42$124275+6.7%
Utah$42$1235340+5.5%
New York$42$11520427+5.4%
Florida$42$110691,256+4.4%
Maryland$41$129519+2.2%
Alabama$40$83516+1.2%
South Carolina$40$126926+0.7%
Missouri$40$104999+0.6%
South Dakota$40$104434+0.3%
Virginia$40$115989+0.2%
Indiana$39$112635-0.9%
Ohio$39$1191756-1.2%
Georgia$39$11917277-1.3%
Colorado$39$98888-2.1%
Louisiana$39$619271-2.8%
Texas$39$9265394-3.1%
Arizona$38$101614-3.4%
Tennessee$38$10922216-3.7%
Minnesota$38$1251030-4.9%
Nebraska$38$911047-5.8%
North Carolina$37$13620371-6.1%
Michigan$37$6323264-7.5%
Wisconsin$36$148617-9.3%
Nevada$36$418499-10.6%
Montana$35$148321-12.4%
Arkansas$35$698199-13.0%
Iowa$34$67681-13.7%
North Dakota$34$111332-14.0%
Oklahoma$34$6216258-14.2%
Kentucky$34$1524152-15.6%
Mississippi$33$52461-17.5%
Kansas$33$48222-18.1%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber