Cost analysis for CPT G0249 — Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the
Average Medicare Payment
$49.36
2023 data
Total Payments (2023)
$57.9M
Services (2023)
882.5K
Price Change (2014–2023)
-42.2%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $85.38 | $114.0M | 1.1M | — |
| 2015 | $86.32 | $128.3M | 1.2M | +1.1% |
| 2016 | $83.10 | $138.0M | 1.3M | -3.7% |
| 2017 | $81.70 | $131.1M | 1.3M | -1.7% |
| 2018 | $64.95 | $105.0M | 1.3M | -20.5% |
| 2019 | $53.08 | $81.1M | 1.2M | -18.3% |
| 2020 | $41.80 | $69.6M | 1.2M | -21.3% |
| 2021 | $43.44 | $57.2M | 1.0M | +3.9% |
| 2022 | $33.28 | $44.5M | 959.2K | -23.4% |
| 2023 | $49.36 | $57.9M | 882.5K | +48.3% |
The most expensive state pays 1.8x more than the cheapest for this procedure. CA averages $67.93 vs FL at $38.57.
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Mdinr, Llc | Independent Diagnostic Testing Facility (IDTF) | CA | $24.5M | 362.4K | $67.56 |
| Alere Home Monitoring, Inc. | Independent Diagnostic Testing Facility (IDTF) | CA | $20.3M | 294.8K | $68.79 |
| Cardionet, Llc. | Independent Diagnostic Testing Facility (IDTF) | CA | $6.5M | 97.0K | $67.08 |
| Raytel Cardiac Services, Inc. | Independent Diagnostic Testing Facility (IDTF) | CT | $2.7M | 51.2K | $52.76 |
| Mdinr, Llc | Independent Diagnostic Testing Facility (IDTF) | NY | $2.7M | 50.2K | $52.95 |
| Tambra Investments, Inc. | Independent Diagnostic Testing Facility (IDTF) | MI | $579.3K | 12.0K | $48.23 |
| Alternative Health Care Inc | Independent Diagnostic Testing Facility (IDTF) | CA | $113.1K | 1.9K | $59.20 |
| Kelie Mercier | Nurse Practitioner | CA | $62.4K | 1.1K | $55.38 |
| Orthodynamics Company, Inc. | Pharmacy | IN | $44.5K | 1.0K | $44.41 |
| Blair Foreman | Clinical Cardiac Electrophysiology | IA | $29.9K | 664 | $44.99 |
| Caitlin Pham | Nurse Practitioner | CA | $26.9K | 388 | $69.28 |
| Rakshak Sarda | Cardiology | IA | $26.3K | 606 | $43.33 |
| Sumit Sehgal | Cardiology | IA | $25.7K | 580 | $44.32 |
| Scott Gabler | Cardiology | NJ | $22.9K | 405 | $56.56 |
| John Michael Chua Chiaco | Interventional Cardiology | IA | $21.4K | 485 | $44.22 |
| Suhas Bhat | Interventional Cardiology | IA | $20.3K | 474 | $42.85 |
| James Meyer | Sleep Medicine | IA | $19.3K | 427 | $45.08 |
| Shahzad Siddique | Hematology-Oncology | CA | $16.1K | 272 | $59.03 |
| Sophie Dao | Nurse Practitioner | CA | $15.6K | 229 | $67.95 |
| Hemalatha Naganna | Cardiology | MD | $14.7K | 277 | $53.17 |
Based on the data, CPT G0249 shows a 1.8x variation in pricing across states — moderate variation by Medicare standards.
Costs have decreased 42.2% 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.