G0407

Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth

Medicare pricing data for 1,301 providers across 42 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

Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth (HCPCS code G0407) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $66.39, but hospitals typically charge $152.11 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.28

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $66.39, your out-of-pocket cost would be approximately $13.28. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$66.39
Average Hospital Charge
$152.11
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$152.11
Medicare Allowed$66.39
Medicare Payment$52.35

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $52.35 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$77$2019124+15.4%
California$74$150751,166+11.8%
New York$74$19936566+11.3%
Illinois$73$14639808+9.9%
Maryland$72$17819185+8.0%
New Jersey$71$17627284+7.6%
Florida$71$2021293,483+7.4%
Washington$71$21121272+7.0%
Puerto Rico$71$169236+6.5%
Massachusetts$71$182752+6.3%
Georgia$70$20833269+5.7%
Arizona$70$2751135+5.4%
Virginia$70$19921246+5.4%
West Virginia$70$20815106+4.9%
Indiana$69$19613595+4.6%
Pennsylvania$69$175103890+4.6%
Minnesota$69$17530255+3.5%
Ohio$68$22254576+3.0%
Colorado$68$22719154+2.8%
Alabama$68$154632+2.6%
South Carolina$68$22121123+2.5%
South Dakota$68$8420554+2.4%
Oregon$68$19726294+2.0%
Nebraska$67$16825388+0.7%
Utah$67$205419+0.5%
District of Columbia$67$191221+0.2%
Missouri$66$18127313+0.1%
North Carolina$66$18541535-0.4%
New Mexico$66$101547-0.5%
Texas$66$1301823,996-0.9%
Michigan$66$14333911-1.3%
Louisiana$65$115301,390-2.2%
Kentucky$65$152940-2.4%
Nevada$64$13510550-3.0%
Wisconsin$64$27327122-3.4%
Kansas$63$91278-4.8%
Iowa$62$13821219-6.3%
North Dakota$61$205413-8.0%
Mississippi$61$968167-8.6%
Tennessee$60$124532,864-10.1%
Arkansas$59$11914701-10.6%
Oklahoma$59$103332,527-11.4%

⚠️ 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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