Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A in South Dakota
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
South Dakota Pricing in Context
In South Dakota, CPT code G0179 (Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A) carries an average Medicare payment of $28.02 — 7% below the national benchmark of $30.17. 100 providers across the state submitted claims for this procedure in 2023, performing 712 total services. Individual payments in SD ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in South Dakota is $104.66, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because South Dakota sits below the national Medicare average, commercial rates in the state may also run lower than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in South Dakota lands near $81.28, with self-pay cash prices typically around $58.52. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A cost in South Dakota?
The average Medicare payment for Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A in South Dakota is $28.02, which is 7% below the national average of $30.17. Providers in SD typically bill $104.66 for this procedure.
What does Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A cost with insurance in South Dakota?
With commercial insurance in South Dakota, Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A costs an estimated $81.28. Without insurance, the estimated cash price is $58.52. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A in South Dakota?
100 providers in South Dakota billed Medicare for Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A in 2023, performing 712 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A cheaper in South Dakota than the national average?
Yes — Physician Or Allowed Practitioner Re-Certification For Medicare-Covered Home Health Services Under A Home Health Plan Of Care (patient Not Present), Including Contacts With Home Health Agency And Review Of Reports Of Patient Status Required By Physicians A costs 7% below the national average in South Dakota. The state average Medicare payment is $28.02 compared to $30.17 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.