HCPCS G9490 at Capital Medical Center

Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code

Capital Medical Center, Olympia

Description from CMS's HCPCS Level II code file.

What Capital Medical Center publishes for this code: as an outpatient

Capital Medical Center’s prices for HCPCS G9490, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$2841 plan	—
Cash pricePaying yourself, without insurance	—	—
List priceBefore any discount; few people pay it	—	—

Lowest and highest amounts Capital Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-08-27. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS G9490 at Capital Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The clinic's facility fee, when the clinic belongs to the hospital	—	The price above
Doctor's visitThe doctor's practice	The visit itself	$53.28	$62.87 – $95.37

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS G9490 at every Washington hospital, with Medicare’s reference amounts.