Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
Medicare pricing data for 2,326 providers across 46 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
Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth (HCPCS code G0425) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $91.20, but hospitals typically charge $284.08 — a 3.1x 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 $91.20, your out-of-pocket cost would be approximately $18.24. 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 3.1x more than what Medicare allows for this procedure. Medicare actually pays $70.73 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Rhode Island | $98 | $300 | 4 | 71 | +7.2% |
| Colorado | $96 | $290 | 72 | 1,040 | +4.7% |
| Illinois | $95 | $367 | 75 | 767 | +4.4% |
| District of Columbia | $95 | $254 | 5 | 12 | +4.2% |
| Washington | $95 | $289 | 53 | 521 | +3.9% |
| California | $94 | $240 | 137 | 1,726 | +3.4% |
| Vermont | $93 | $330 | 5 | 51 | +2.1% |
| Florida | $93 | $299 | 286 | 7,282 | +1.9% |
| Massachusetts | $93 | $301 | 39 | 140 | +1.6% |
| Arizona | $93 | $305 | 29 | 471 | +1.6% |
| Oregon | $93 | $300 | 36 | 526 | +1.5% |
| Oklahoma | $92 | $254 | 29 | 507 | +1.4% |
| New York | $92 | $263 | 129 | 4,356 | +1.1% |
| Iowa | $92 | $242 | 4 | 21 | +1.1% |
| Wisconsin | $92 | $314 | 35 | 244 | +1.0% |
| Maryland | $92 | $294 | 42 | 372 | +0.7% |
| Alabama | $91 | $238 | 28 | 368 | +0.2% |
| Michigan | $91 | $238 | 102 | 613 | +0.2% |
| Connecticut | $91 | $281 | 11 | 79 | +0.1% |
| Pennsylvania | $91 | $274 | 190 | 1,223 | -0.6% |
| Virginia | $91 | $223 | 66 | 650 | -0.8% |
| Arkansas | $91 | $278 | 7 | 105 | -0.8% |
| Indiana | $90 | $245 | 27 | 236 | -0.8% |
| North Carolina | $90 | $276 | 67 | 1,026 | -0.9% |
| Georgia | $90 | $268 | 67 | 951 | -1.0% |
| West Virginia | $90 | $283 | 37 | 271 | -1.3% |
| South Dakota | $90 | $280 | 4 | 44 | -1.6% |
| Utah | $90 | $261 | 15 | 214 | -1.6% |
| South Carolina | $90 | $262 | 39 | 532 | -1.7% |
| North Dakota | $90 | $284 | 3 | 27 | -1.8% |
| Texas | $89 | $229 | 170 | 2,005 | -2.1% |
| Missouri | $89 | $317 | 58 | 811 | -2.6% |
| New Mexico | $89 | $422 | 8 | 33 | -2.7% |
| Louisiana | $89 | $289 | 34 | 412 | -3.0% |
| Ohio | $88 | $547 | 100 | 984 | -3.3% |
| Maine | $88 | $244 | 9 | 18 | -3.5% |
| Mississippi | $86 | $251 | 26 | 198 | -5.4% |
| Puerto Rico | $86 | $296 | 3 | 30 | -5.5% |
| Hawaii | $86 | $198 | 6 | 59 | -5.6% |
| Tennessee | $86 | $240 | 73 | 802 | -5.7% |
| Nebraska | $86 | $236 | 22 | 37 | -5.8% |
| New Jersey | $85 | $278 | 37 | 1,598 | -6.7% |
| Minnesota | $84 | $274 | 74 | 483 | -8.1% |
| Kentucky | $82 | $269 | 6 | 38 | -10.4% |
| New Hampshire | $80 | $335 | 3 | 25 | -12.4% |
| Nevada | $80 | $243 | 7 | 75 | -12.5% |
⚠️ 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