Extensive (75 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 in Pennsylvania
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Pennsylvania Pricing in Context
In Pennsylvania, CPT code G2013 (Extensive (75 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) carries an average Medicare payment of $170.31 — 1% above the national benchmark of $169.18. 15 providers across the state submitted claims for this procedure in 2023, performing 18 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 $426.00, 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 $470.25, with self-pay cash prices typically around $277.46. 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 Extensive (75 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 cost in Pennsylvania?
The average Medicare payment for Extensive (75 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 in Pennsylvania is $170.31, which is 1% above the national average of $169.18. Providers in PA typically bill $426.00 for this procedure.
What does Extensive (75 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 cost with insurance in Pennsylvania?
With commercial insurance in Pennsylvania, Extensive (75 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 costs an estimated $470.25. Without insurance, the estimated cash price is $277.46. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Extensive (75 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 in Pennsylvania?
15 providers in Pennsylvania billed Medicare for Extensive (75 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 in 2023, performing 18 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Extensive (75 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 cheaper in Pennsylvania than the national average?
No — Extensive (75 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 costs 1% above the national average in Pennsylvania. The state average Medicare payment is $170.31 compared to $169.18 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.