Louisiana · G0402

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

Louisiana Medicare Avg
$149.35
4% below national avg
National Medicare Avg
$155.38
All states combined
Billed Charge (LA)
$271.13
What providers submit
Est. Commercial (LA)
$336.04
National avg: $348.05
Est. Cash / Self-Pay (LA)
$186.57
Typical self-pay discount

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

5.6K
Services in LA
1.0K
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Louisiana

Provider Medicare Services
Menard, Darrin MD $128.11 38

Louisiana Pricing in Context

In Louisiana, 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 $149.35 — 4% below the national benchmark of $155.38. 1.0K providers across the state submitted claims for this procedure in 2023, performing 5.6K total services. Individual payments in LA 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 Louisiana is $271.13, 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 Louisiana 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 Louisiana lands near $336.04, with self-pay cash prices typically around $186.57. 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 Louisiana?

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 Louisiana is $149.35, which is 4% below the national average of $155.38. Providers in LA typically bill $271.13 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 Louisiana?

With commercial insurance in Louisiana, Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment costs an estimated $336.04. Without insurance, the estimated cash price is $186.57. 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 Louisiana?

1.0K providers in Louisiana 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 5.6K 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 Louisiana 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 4% below the national average in Louisiana. The state average Medicare payment is $149.35 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