HCPCS G9490

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

Current code11 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS G9490 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27———
Deaconess Medical CenterSpokaneFile dated 2026-08-27———
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01———
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27———
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27———
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27———
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27———
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27———
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27———
Virginia Mason Medical CenterSeattle$55.05 – $48012 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County)
$61.23 in an office; $61.23 in a hospital or surgery center
Doctor's fee, rest of Washington
$53.28 in an office; $53.28 in a hospital or surgery center