Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment in Tennessee
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Tennessee
| Provider | Medicare | Services |
|---|---|---|
| Buttross, John MD | $153.09 | 61 |
| Franklin, E MD | $153.09 | 52 |
| Luttrell, Douglas NP | $129.71 | 44 |
| Katz, Paul MD | $151.02 | 44 |
| Wood, Kenneth MD | $152.98 | 42 |
| Campbell, Tommy MD | $152.78 | 42 |
| Rushing, George MD | $153.09 | 38 |
| Sammons, Fred DO | $148.48 | 34 |
| Hayden, Shawn M.D. | $142.00 | 34 |
| Simms, Allison D.O. | $149.45 | 34 |
Tennessee Pricing in Context
In Tennessee, 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 $143.54 — 8% below the national benchmark of $155.38. 2.5K providers across the state submitted claims for this procedure in 2023, performing 14.3K total services. Individual payments in TN 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 Tennessee is $325.25, 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 Tennessee 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 Tennessee lands near $308.62, with self-pay cash prices typically around $197.10. 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 Tennessee?
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 Tennessee is $143.54, which is 8% below the national average of $155.38. Providers in TN typically bill $325.25 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 Tennessee?
With commercial insurance in Tennessee, Initial Preventive Physical Examination; Face-To-Face Visit, Services Limited To New Beneficiary During The First 12 Months Of Medicare Enrollment costs an estimated $308.62. Without insurance, the estimated cash price is $197.10. 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 Tennessee?
2.5K providers in Tennessee 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 14.3K 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 Tennessee 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 8% below the national average in Tennessee. The state average Medicare payment is $143.54 compared to $155.38 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.