Initial care coordination fee, Medicare demonstration program

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR Coordinated Care Fee Initial Rate

Payers reporting HCPCS G9001

Payer pricing summary

Low

Average

$136

Median

$140

High

$356

Payer rate distribution

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#
1	Blue Cross Blue Shield professional · fee schedule · both · +10 other terms	13	$153	$148	$3	2%	69–132	$147 – $158
2	Highmark professional · fee schedule · both · +3 other terms	3	$147	$147	—	—	1–10	$147 – $147
3	Premera professional · fee schedule · both · +2 other terms	3	$147	$147	—	—	1–10	$147 – $147
4	Molina facility · case rate · outpatient · +11 other terms	27	$32	$60	$44	73%	—	$14 – $182
5	Aetna fee schedule · outpatient · +14 other terms	24	$0	$24	$60	246%	—	$0 – $174
6	UnitedHealthcare facility · case rate · outpatient · +11 other terms	17	$21	$32	$24	74%	—	$14 – $88
7	Anthem facility · case rate · outpatient · +9 other terms	15	$20	$22	$5	23%	—	$13 – $34
8	Caresource facility · case rate · outpatient · +1 other terms	15	$20	$22	$5	23%	—	$13 – $34
9	Optum facility · case rate · outpatient	13	$19	$29	$20	70%	—	$17 – $76
10	Cigna professional · fee schedule · both · +7 other terms	11	$154	$144	$33	23%	—	$41 – $154
11	Humana fee schedule · outpatient · +10 other terms	9	$0	$81	$90	112%	—	$0 – $183
12	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$0	$0	—	—	—	$0 – $0
13	Amerihealth Caritas facility · case rate · outpatient · +2 other terms	7	$88	$89	$3	3%	—	$88 – $96
14	MultiPlan professional · percent of total billed charges · bothfrom % of charges · +5 other terms	4	$170	$167	$39	23%	—	$109 – $218
15	Carefirst professional · fee schedule · both · +2 other terms	3	$147	$147	—	—	—	$147 – $147
16	Excellus professional · fee schedule · both · +3 other terms	3	$147	$147	—	—	—	$147 – $147
17	First Health professional · fee schedule · both · +6 other terms	3	$0	$0	—	—	—	$0 – $0
18	Medcost professional · percent of total billed charges · bothfrom % of charges · +2 other terms	3	$141	$157	$23	15%	—	$141 – $190
19	Medical Mutual professional · percent of total billed charges · bothfrom % of charges · +2 other terms	3	$141	$157	$23	15%	—	$141 – $190
20	Phcs professional · percent of total billed charges · bothfrom % of charges · +3 other terms	3	$170	$186	$23	12%	—	$170 – $218
21	Regence professional · fee schedule · both · +2 other terms	3	$147	$147	—	—	—	$147 – $147
22	Tricare professional · percent of total billed charges · bothfrom % of charges · +2 other terms	3	$194	$213	$26	12%	—	$194 – $250
23	Wellmark facility · case rate · outpatient · +3 other terms	3	$309	$271	$85	32%	—	$126 – $341
24	Medicaid facility · case rate · outpatient	2	$80	$80	—	—	—	$80 – $80
25	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0

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