Prolonged Home Or Residence 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 Qualif in Colorado
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Colorado
| Provider | Medicare | Services |
|---|---|---|
| Gorton, Jami AGNP | $20.96 | 38 |
Colorado Pricing in Context
In Colorado, CPT code G0318 (Prolonged Home Or Residence 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 Qualif) carries an average Medicare payment of $20.86 — 6% below the national benchmark of $22.10. 81 providers across the state submitted claims for this procedure in 2023, performing 943 total services. Individual payments in CO 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 Colorado is $67.92, 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 Colorado 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 Colorado lands near $61.51, with self-pay cash prices typically around $38.74. 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 Home Or Residence 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 Qualif cost in Colorado?
The average Medicare payment for Prolonged Home Or Residence 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 Qualif in Colorado is $20.86, which is 6% below the national average of $22.10. Providers in CO typically bill $67.92 for this procedure.
What does Prolonged Home Or Residence 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 Qualif cost with insurance in Colorado?
With commercial insurance in Colorado, Prolonged Home Or Residence 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 Qualif costs an estimated $61.51. Without insurance, the estimated cash price is $38.74. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Prolonged Home Or Residence 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 Qualif in Colorado?
81 providers in Colorado billed Medicare for Prolonged Home Or Residence 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 Qualif in 2023, performing 943 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Prolonged Home Or Residence 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 Qualif cheaper in Colorado than the national average?
Yes — Prolonged Home Or Residence 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 Qualif costs 6% below the national average in Colorado. The state average Medicare payment is $20.86 compared to $22.10 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.