Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, in Massachusetts
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Massachusetts Pricing in Context
In Massachusetts, CPT code G0323 (Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring,) carries an average Medicare payment of $18.41 — 36% below the national benchmark of $28.67. 1 providers across the state submitted claims for this procedure in 2023, performing 52 total services. Individual payments in MA 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 Massachusetts is $105.00, 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 Massachusetts 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 Massachusetts lands near $60.09, with self-pay cash prices typically around $46.21. 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 Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, cost in Massachusetts?
The average Medicare payment for Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, in Massachusetts is $18.41, which is 36% below the national average of $28.67. Providers in MA typically bill $105.00 for this procedure.
What does Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, cost with insurance in Massachusetts?
With commercial insurance in Massachusetts, Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, costs an estimated $60.09. Without insurance, the estimated cash price is $46.21. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, in Massachusetts?
1 providers in Massachusetts billed Medicare for Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, in 2023, performing 52 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, cheaper in Massachusetts than the national average?
Yes — Care Management Services For Behavioral Health Conditions, At Least 20 Minutes Of Clinical Psychologist Or Clinical Social Worker Time, Per Calendar Month. (these Services Include The Following Required Elements: Initial Assessment Or Follow-Up Monitoring, costs 36% below the national average in Massachusetts. The state average Medicare payment is $18.41 compared to $28.67 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.