Physician Or Allowed Practitioner 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 And in Tennessee
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Tennessee
| Provider | Medicare | Services |
|---|---|---|
| Wallstedt, Bruce MD | $36.02 | 550 |
| Rucker, Walter MD | $37.46 | 364 |
| Glover, Sherry NP | $30.88 | 242 |
| Gupta, Rajeev MD | $36.25 | 221 |
Tennessee Pricing in Context
In Tennessee, CPT code G0180 (Physician Or Allowed Practitioner 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 And) carries an average Medicare payment of $35.93 — 9% below the national benchmark of $39.49. 2.1K providers across the state submitted claims for this procedure in 2023, performing 25.1K total services. Individual payments in TN 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 Tennessee is $115.80, 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 Tennessee 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 Tennessee lands near $101.52, with self-pay cash prices typically around $67.26. 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 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 And cost in Tennessee?
The average Medicare payment for Physician Or Allowed Practitioner 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 And in Tennessee is $35.93, which is 9% below the national average of $39.49. Providers in TN typically bill $115.80 for this procedure.
What does Physician Or Allowed Practitioner 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 And cost with insurance in Tennessee?
With commercial insurance in Tennessee, Physician Or Allowed Practitioner 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 And costs an estimated $101.52. Without insurance, the estimated cash price is $67.26. 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 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 And in Tennessee?
2.1K providers in Tennessee billed Medicare for Physician Or Allowed Practitioner 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 And in 2023, performing 25.1K total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Physician Or Allowed Practitioner 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 And cheaper in Tennessee than the national average?
Yes — Physician Or Allowed Practitioner 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 And costs 9% below the national average in Tennessee. The state average Medicare payment is $35.93 compared to $39.49 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.