Pennsylvania · G2252

Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic in Pennsylvania

Pennsylvania Medicare Avg
$18.53
1% below national avg
National Medicare Avg
$18.68
All states combined
Billed Charge (PA)
$72.74
What providers submit
Est. Commercial (PA)
$57.94
National avg: $57.51
Est. Cash / Self-Pay (PA)
$39.76
Typical self-pay discount

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

27
Services in PA
11
Providers
N/A
Min Payment
N/A
Max Payment

Pennsylvania Pricing in Context

In Pennsylvania, CPT code G2252 (Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic) carries an average Medicare payment of $18.53 — 1% below the national benchmark of $18.68. 11 providers across the state submitted claims for this procedure in 2023, performing 27 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 $72.74, 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 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 Temporary Procedures procedures, the estimated commercial insurance price in Pennsylvania lands near $57.94, with self-pay cash prices typically around $39.76. 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 Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic cost in Pennsylvania?

The average Medicare payment for Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic in Pennsylvania is $18.53, which is 1% below the national average of $18.68. Providers in PA typically bill $72.74 for this procedure.

What does Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic cost with insurance in Pennsylvania?

With commercial insurance in Pennsylvania, Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic costs an estimated $57.94. Without insurance, the estimated cash price is $39.76. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic in Pennsylvania?

11 providers in Pennsylvania billed Medicare for Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic in 2023, performing 27 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic cheaper in Pennsylvania than the national average?

Yes — Brief Communication Technology-Based Service, E.g. Virtual Check-In, By A Physician Or Other Qualified Health Care Professional Who Can Report Evaluation And Management Services, Provided To An Established Patient, Not Originating From A Related E/m Servic costs 1% below the national average in Pennsylvania. The state average Medicare payment is $18.53 compared to $18.68 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