Vermont · G0246

Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) in Vermont

Vermont Medicare Avg
$13.04
47% below national avg
National Medicare Avg
$24.66
All states combined
Billed Charge (VT)
$40.02
What providers submit
Est. Commercial (VT)
$42.70
National avg: $77.80
Est. Cash / Self-Pay (VT)
$25.56
Typical self-pay discount

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

97
Services in VT
2
Providers
N/A
Min Payment
N/A
Max Payment

Vermont Pricing in Context

In Vermont, CPT code G0246 (Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a)) carries an average Medicare payment of $13.04 — 47% below the national benchmark of $24.66. 2 providers across the state submitted claims for this procedure in 2023, performing 97 total services. Individual payments in VT 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 Vermont is $40.02, 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 Vermont 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 Vermont lands near $42.70, with self-pay cash prices typically around $25.56. 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 Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) cost in Vermont?

The average Medicare payment for Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) in Vermont is $13.04, which is 47% below the national average of $24.66. Providers in VT typically bill $40.02 for this procedure.

What does Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) cost with insurance in Vermont?

With commercial insurance in Vermont, Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) costs an estimated $42.70. Without insurance, the estimated cash price is $25.56. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) in Vermont?

2 providers in Vermont billed Medicare for Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) in 2023, performing 97 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) cheaper in Vermont than the national average?

Yes — Follow-Up Physician Evaluation And Management Of A Diabetic Patient With Diabetic Sensory Neuropathy Resulting In A Loss Of Protective Sensation (lops) To Include At Least The Following: (1) A Patient History, (2) A Physical Examination That Includes: (a) costs 47% below the national average in Vermont. The state average Medicare payment is $13.04 compared to $24.66 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