Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
Medicare pricing data for 791 providers across 30 states
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
Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour (HCPCS code G0420) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $100.55, but hospitals typically charge $231.72 — a 2.3x 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 $100.55, your out-of-pocket cost would be approximately $20.11. 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 2.3x more than what Medicare allows for this procedure. Medicare actually pays $75.75 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $118 | $291 | 26 | 315 | +17.7% |
| Florida | $107 | $259 | 72 | 416 | +6.0% |
| Nevada | $106 | $594 | 36 | 200 | +5.7% |
| California | $106 | $245 | 53 | 193 | +5.6% |
| Louisiana | $106 | $195 | 7 | 78 | +5.5% |
| Arizona | $106 | $224 | 55 | 240 | +5.4% |
| Maryland | $104 | $286 | 8 | 63 | +2.9% |
| Georgia | $103 | $213 | 26 | 193 | +2.3% |
| Pennsylvania | $102 | $198 | 63 | 328 | +1.7% |
| New Jersey | $102 | $214 | 49 | 535 | +1.6% |
| South Carolina | $102 | $212 | 6 | 16 | +1.0% |
| Texas | $101 | $177 | 59 | 619 | +0.8% |
| Alabama | $101 | $152 | 5 | 18 | +0.2% |
| Illinois | $100 | $174 | 52 | 468 | -0.6% |
| Virginia | $100 | $195 | 18 | 186 | -0.7% |
| Missouri | $96 | $269 | 12 | 108 | -4.0% |
| Kentucky | $96 | $164 | 14 | 42 | -4.3% |
| Indiana | $96 | $202 | 26 | 127 | -4.8% |
| Michigan | $95 | $189 | 22 | 179 | -5.2% |
| Ohio | $95 | $271 | 12 | 47 | -6.0% |
| North Carolina | $94 | $178 | 102 | 698 | -6.1% |
| Oregon | $94 | $293 | 9 | 55 | -6.2% |
| North Dakota | $91 | $316 | 4 | 34 | -9.2% |
| Oklahoma | $91 | $188 | 2 | 12 | -9.9% |
| Minnesota | $90 | $292 | 6 | 36 | -10.4% |
| New Mexico | $89 | $216 | 2 | 45 | -11.0% |
| Tennessee | $89 | $318 | 17 | 409 | -11.4% |
| Maine | $89 | $153 | 3 | 21 | -11.8% |
| Iowa | $87 | $135 | 3 | 49 | -13.0% |
| Mississippi | $86 | $276 | 1 | 32 | -14.2% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber