New York · G0181

Physician Or Allowed Practitioner Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow in New York

New York Medicare Avg
$86.79
7% above national avg
National Medicare Avg
$80.93
All states combined
Billed Charge (NY)
$216.41
What providers submit
Est. Commercial (NY)
$279.63
National avg: $232.86
Est. Cash / Self-Pay (NY)
$143.40
Typical self-pay discount

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

6.0K
Services in NY
267
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in New York

Provider Medicare Services
Schulz, Thadeus MD $82.08 1.8K
Hijazin, Eyad M.D $90.45 204
Mechanick, Jeffrey M.D. $93.16 154
Palekar, Shashishekhar MD $94.50 141
Blum, Daniel MD $94.70 131

New York Pricing in Context

In New York, CPT code G0181 (Physician Or Allowed Practitioner Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow) carries an average Medicare payment of $86.79 — 7% above the national benchmark of $80.93. 267 providers across the state submitted claims for this procedure in 2023, performing 6.0K total services. Individual payments in NY 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 New York is $216.41, 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 New York sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in New York lands near $279.63, with self-pay cash prices typically around $143.40. 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 Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow cost in New York?

The average Medicare payment for Physician Or Allowed Practitioner Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow in New York is $86.79, which is 7% above the national average of $80.93. Providers in NY typically bill $216.41 for this procedure.

What does Physician Or Allowed Practitioner Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow cost with insurance in New York?

With commercial insurance in New York, Physician Or Allowed Practitioner Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow costs an estimated $279.63. Without insurance, the estimated cash price is $143.40. 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 Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow in New York?

267 providers in New York billed Medicare for Physician Or Allowed Practitioner Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow in 2023, performing 6.0K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Physician Or Allowed Practitioner Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow cheaper in New York than the national average?

No — Physician Or Allowed Practitioner Supervision Of A Patient Receiving Medicare-Covered Services Provided By A Participating Home Health Agency (patient Not Present) Requiring Complex And Multidisciplinary Care Modalities Involving Regular Physician Or Allow costs 7% above the national average in New York. The state average Medicare payment is $86.79 compared to $80.93 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