Pennsylvania · G2007

Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da in Pennsylvania

Pennsylvania Medicare Avg
$63.94
3% above national avg
National Medicare Avg
$62.37
All states combined
Billed Charge (PA)
$160.00
What providers submit
Est. Commercial (PA)
$176.55
National avg: $176.69
Est. Cash / Self-Pay (PA)
$104.19
Typical self-pay discount

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

11
Services in PA
11
Providers
N/A
Min Payment
N/A
Max Payment

Pennsylvania Pricing in Context

In Pennsylvania, CPT code G2007 (Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da) carries an average Medicare payment of $63.94 — 3% above the national benchmark of $62.37. 11 providers across the state submitted claims for this procedure in 2023, performing 11 total services. Individual payments in PA 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 Pennsylvania is $160.00, 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 Pennsylvania sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in Pennsylvania lands near $176.55, with self-pay cash prices typically around $104.19. 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 Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da cost in Pennsylvania?

The average Medicare payment for Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da in Pennsylvania is $63.94, which is 3% above the national average of $62.37. Providers in PA typically bill $160.00 for this procedure.

What does Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da cost with insurance in Pennsylvania?

With commercial insurance in Pennsylvania, Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da costs an estimated $176.55. Without insurance, the estimated cash price is $104.19. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da in Pennsylvania?

11 providers in Pennsylvania billed Medicare for Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da in 2023, performing 11 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da cheaper in Pennsylvania than the national average?

No — Limited (30 Minutes) In-Home Visit For An Existing Patient Post-Discharge. For Use Only In A Medicare-Approved Cmmi Model. (services Must Be Furnished Within A Beneficiary's Home, Domiciliary, Rest Home, Assisted Living And/or Nursing Facility Within 90 Da costs 3% above the national average in Pennsylvania. The state average Medicare payment is $63.94 compared to $62.37 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