Texas · 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 in Texas

Texas Medicare Avg
$38.29
3% below national avg
National Medicare Avg
$39.49
All states combined
Billed Charge (TX)
$116.32
What providers submit
Est. Commercial (TX)
$114.51
National avg: $114.95
Est. Cash / Self-Pay (TX)
$69.33
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

66.4K
Services in TX
5.0K
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Texas

Provider Medicare Services
Ho, Nhue M.D. $38.48 1.6K
Ho, Tao M.D. $38.64 1.2K
Campbell, Odette M.D. $40.30 401
Cable, James M.D. $41.39 254
Rivero, Angelina MD $37.10 241
Lucchese, Christopher DO $39.73 235
Tuamokumo, Timi M.D. $39.60 230
Sreerama, Ravi M.D. $41.73 225
Yu, Hsiling FNP-C $35.26 196
Tran, Kenny-Bao MD $40.74 189

Texas Pricing in Context

In Texas, 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 $38.29 — 3% below the national benchmark of $39.49. 5.0K providers across the state submitted claims for this procedure in 2023, performing 66.4K total services. Individual payments in TX 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 Texas is $116.32, 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 Texas 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 Texas lands near $114.51, with self-pay cash prices typically around $69.33. 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 Texas?

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 Texas is $38.29, which is 3% below the national average of $39.49. Providers in TX typically bill $116.32 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 Texas?

With commercial insurance in Texas, 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 $114.51. Without insurance, the estimated cash price is $69.33. 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 Texas?

5.0K providers in Texas 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 66.4K 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 Texas 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 3% below the national average in Texas. The state average Medicare payment is $38.29 compared to $39.49 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial