Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi in Virginia
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Virginia
| Provider | Medicare | Services |
|---|---|---|
| Danner, James D.O. | $23.76 | 382 |
| Danner, James D.O. | $24.89 | 151 |
| Ayele, Petros MD INTERNAL MED. | $24.37 | 70 |
Virginia Pricing in Context
In Virginia, CPT code G0317 (Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi) carries an average Medicare payment of $22.14 — 2% above the national benchmark of $21.61. 179 providers across the state submitted claims for this procedure in 2023, performing 4.4K total services. Individual payments in VA 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 Virginia is $60.31, 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 Virginia 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 Virginia lands near $61.64, with self-pay cash prices typically around $37.60. 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 Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi cost in Virginia?
The average Medicare payment for Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi in Virginia is $22.14, which is 2% above the national average of $21.61. Providers in VA typically bill $60.31 for this procedure.
What does Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi cost with insurance in Virginia?
With commercial insurance in Virginia, Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi costs an estimated $61.64. Without insurance, the estimated cash price is $37.60. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi in Virginia?
179 providers in Virginia billed Medicare for Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi in 2023, performing 4.4K total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi cheaper in Virginia than the national average?
No — Prolonged Nursing Facility Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By The Physician Or Qualifi costs 2% above the national average in Virginia. The state average Medicare payment is $22.14 compared to $21.61 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.