Cost analysis for CPT G0180 — Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and
Average Medicare Payment
$39.31
2023 data
Total Payments (2023)
$28.3M
Services (2023)
711.2K
Price Change (2014–2023)
-2.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $40.44 | $46.3M | 1.1M | — |
| 2015 | $40.80 | $45.7M | 1.1M | +0.9% |
| 2016 | $40.49 | $45.2M | 1.1M | -0.8% |
| 2017 | $40.79 | $44.7M | 1.1M | +0.7% |
| 2018 | $41.01 | $42.5M | 1.0M | +0.5% |
| 2019 | $41.27 | $42.9M | 1.0M | +0.6% |
| 2020 | $41.43 | $37.7M | 904.7K | +0.4% |
| 2021 | $40.90 | $34.6M | 838.7K | -1.3% |
| 2022 | $40.41 | $30.8M | 754.1K | -1.2% |
| 2023 | $39.31 | $28.3M | 711.2K | -2.7% |
The most expensive state pays 1.3x more than the cheapest for this procedure. GU averages $47.28 vs MS at $35.86.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| GU | $47.28 | $13.2K | 280 | 3 |
| NY | $44.28 | $1.1M | 24.7K | 639 |
| CA | $44.25 | $5.0M | 113.0K | 1.5K |
| NJ | $43.95 | $551.5K | 12.5K | 381 |
| DC | $43.29 | $21.8K | 504 | 20 |
| MA | $42.07 | $1.3M | 30.1K | 924 |
| CT | $42.06 | $493.1K | 11.7K | 379 |
| MD | $41.87 | $530.8K | 12.7K | 402 |
| IL | $41.24 | $1.8M | 44.0K | 978 |
| RI | $41.05 | $48.6K | 1.2K | 43 |
| CO | $40.47 | $195.5K | 4.8K | 110 |
| DE | $40.01 | $93.8K | 2.3K | 95 |
| NH | $39.87 | $132.7K | 3.3K | 123 |
| WA | $39.57 | $366.4K | 9.3K | 271 |
| PA | $39.54 | $853.2K | 21.6K | 847 |
| ME | $39.48 | $46.1K | 1.2K | 30 |
| ND | $39.43 | $25.2K | 640 | 33 |
| SD | $39.19 | $19.2K | 490 | 22 |
| VA | $39.17 | $645.1K | 16.5K | 538 |
| FL | $38.99 | $4.6M | 117.7K | 2.4K |
| WY | $38.92 | $4.9K | 125 | 6 |
| MT | $38.71 | $10.5K | 270 | 9 |
| TX | $38.37 | $2.0M | 52.1K | 1.5K |
| MI | $38.33 | $734.3K | 19.2K | 547 |
| MO | $38.29 | $187.6K | 4.9K | 186 |
| GA | $38.28 | $539.0K | 14.1K | 431 |
| NV | $38.17 | $361.0K | 9.5K | 117 |
| MN | $38.12 | $262.2K | 6.9K | 305 |
| AZ | $37.95 | $407.6K | 10.7K | 240 |
| SC | $37.17 | $485.2K | 13.1K | 377 |
| NM | $37.17 | $42.5K | 1.1K | 38 |
| OR | $37.12 | $52.0K | 1.4K | 55 |
| LA | $37.10 | $487.2K | 13.1K | 489 |
| OH | $37.02 | $788.9K | 21.3K | 747 |
| NC | $36.87 | $621.1K | 16.8K | 662 |
| WI | $36.86 | $189.3K | 5.1K | 202 |
| VT | $36.79 | $50.5K | 1.4K | 64 |
| NE | $36.73 | $55.3K | 1.5K | 67 |
| UT | $36.63 | $138.1K | 3.8K | 112 |
| KY | $36.49 | $276.5K | 7.6K | 247 |
| IN | $36.44 | $256.8K | 7.0K | 271 |
| WV | $36.43 | $70.3K | 1.9K | 75 |
| AL | $36.42 | $518.0K | 14.2K | 517 |
| ID | $36.33 | $55.2K | 1.5K | 67 |
| KS | $36.26 | $157.3K | 4.3K | 149 |
| AR | $36.22 | $207.7K | 5.7K | 215 |
| IA | $36.20 | $60.5K | 1.7K | 84 |
| TN | $36.17 | $683.5K | 18.9K | 556 |
| OK | $36.16 | $444.6K | 12.3K | 431 |
| MS | $35.86 | $389.3K | 10.9K | 359 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Maria Ortiz | Family Practice | CA | $122.3K | 2.7K | $44.87 |
| Daisy Bautista | Family Practice | CA | $100.6K | 2.2K | $45.34 |
| Maria Lourdes De Leon | Family Practice | CA | $97.7K | 2.2K | $45.41 |
| Hermilito Villar | General Practice | CA | $94.6K | 2.2K | $43.96 |
| Evelyn Basco | Preventive Medicine | IL | $91.0K | 2.0K | $45.61 |
| Mark Samonte | General Practice | CA | $87.1K | 1.9K | $44.98 |
| Linda Enriquez | Pathology | CA | $82.0K | 1.8K | $45.43 |
| Anand Mahadevan | Internal Medicine | FL | $81.4K | 2.0K | $40.98 |
| Danielle Whitacre | Family Practice | CO | $79.8K | 1.9K | $41.39 |
| Policarpoi Enriquez | Physical Medicine and Rehabilitation | CA | $63.4K | 1.4K | $45.50 |
| Nicola Azar | Family Practice | CA | $63.3K | 1.4K | $45.05 |
| Catherine Noel-Uyloan | Family Practice | CA | $62.0K | 1.4K | $45.62 |
| Nhue Ho | Internal Medicine | TX | $61.2K | 1.6K | $38.48 |
| Gabriel Rizzi | Family Practice | FL | $60.5K | 1.5K | $40.28 |
| Lisa Laya | Infectious Disease | TN | $60.1K | 1.6K | $37.78 |
| Daniel Linares | Family Practice | CA | $59.1K | 1.3K | $45.15 |
| James Howard | Emergency Medicine | CA | $57.8K | 1.3K | $43.68 |
| Dan Azar | Preventive Medicine | CA | $55.9K | 1.2K | $45.00 |
| Daniel Radnia | General Practice | CA | $52.2K | 1.2K | $43.85 |
| Paula Bailey-Walton | Internal Medicine | CA | $50.6K | 1.1K | $44.66 |
Based on the data, CPT G0180 shows a 1.3x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 2.8% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.