G0446

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes

Medicare pricing data for 6,111 providers across 50 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

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes (HCPCS code G0446) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $25.46, but hospitals typically charge $50.01 — a 2.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.09

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $25.46, your out-of-pocket cost would be approximately $5.09. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$25.46
Average Hospital Charge
$50.01
Markup Ratio
2.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$50.01
Medicare Allowed$25.46
Medicare Payment$25.46

Hospitals charge 2.0x more than what Medicare allows for this procedure. Medicare actually pays $25.46 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$29$6262626,214+13.4%
District of Columbia$28$46574+10.2%
New Jersey$28$5619814,151+9.2%
California$27$5766344,263+7.2%
Alaska$27$599177+7.0%
Maryland$27$491076,256+6.5%
Connecticut$27$47331,599+6.2%
Illinois$27$521006,773+5.0%
New Hampshire$26$35481+1.8%
Florida$26$4568547,341+1.3%
Rhode Island$26$4624450+1.2%
Colorado$26$45774,420+0.2%
Nevada$25$52955,413-0.0%
Virginia$25$441287,369-0.1%
Michigan$25$47934,208-0.2%
Delaware$25$419852-0.2%
Vermont$25$33414-0.4%
Massachusetts$25$551445,671-0.4%
North Dakota$25$421119-1.2%
Pennsylvania$25$421326,911-1.3%
Oregon$25$6936768-2.0%
Ohio$25$541504,485-2.9%
Utah$25$3722654-2.9%
Hawaii$25$29880-3.5%
Texas$25$4647322,927-3.6%
Missouri$25$45603,654-3.7%
Louisiana$24$53501,647-3.9%
Washington$24$701505,401-4.2%
Georgia$24$4928015,597-4.6%
Wisconsin$24$5816467-5.3%
Kansas$24$51181,123-5.4%
North Carolina$24$4638514,063-5.5%
New Mexico$24$4213270-5.7%
Idaho$24$5310590-6.5%
Indiana$24$58501,258-6.5%
West Virginia$24$4722853-7.2%
Kentucky$23$40401,814-7.7%
Oklahoma$23$49592,603-7.8%
Iowa$23$6222771-7.9%
South Carolina$23$4927723,370-8.1%
Arizona$23$4229419,401-8.1%
Maine$23$314174-9.2%
Alabama$23$381927,599-9.2%
Tennessee$23$471767,813-9.4%
Mississippi$23$46814,731-10.9%
Arkansas$23$36241,515-11.0%
Montana$22$2815465-11.7%
Minnesota$22$425136-14.0%
Nebraska$22$4020639-14.4%
Wyoming$22$36211-15.1%

⚠️ 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