Arkansas · G0402

Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment in Arkansas

Arkansas Medicare Avg
$137.95
11% below national avg
National Medicare Avg
$155.38
All states combined
Billed Charge (AR)
$283.88
What providers submit
Est. Commercial (AR)
$289.69
National avg: $348.05
Est. Cash / Self-Pay (AR)
$181.53
Typical self-pay discount

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

4.8K
Services in AR
938
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Arkansas

Provider Medicare Services
Bradberry, Andrew DO $157.93 39
Norys, James MD $128.92 33

Arkansas Pricing in Context

In Arkansas, CPT code G0402 (Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment) carries an average Medicare payment of $137.95 — 11% below the national benchmark of $155.38. 938 providers across the state submitted claims for this procedure in 2023, performing 4.8K total services. Individual payments in AR 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 Arkansas is $283.88, 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 Arkansas 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 Preventive Screening procedures, the estimated commercial insurance price in Arkansas lands near $289.69, with self-pay cash prices typically around $181.53. 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 Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment cost in Arkansas?

The average Medicare payment for Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment in Arkansas is $137.95, which is 11% below the national average of $155.38. Providers in AR typically bill $283.88 for this procedure.

What does Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment cost with insurance in Arkansas?

With commercial insurance in Arkansas, Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment costs an estimated $289.69. Without insurance, the estimated cash price is $181.53. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment in Arkansas?

938 providers in Arkansas billed Medicare for Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment in 2023, performing 4.8K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment cheaper in Arkansas than the national average?

Yes — Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment costs 11% below the national average in Arkansas. The state average Medicare payment is $137.95 compared to $155.38 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