Home Health & Neuromuscular Rehab Visit (CPT 99349 / CPT 97112): Cost Across Insurances
Complete cell-by-cell comparison across Self-Pay Cash, Original Medicare, 6 Major California Commercial Payers (Anthem, Blue Shield, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente), and Medi-Cal — with every cell labeled with its official data source and effective date.
Accuracy Level — Tier 1 Published Prices: You are currently viewing general published hospital cash prices, Medicare baselines, and multi-payer ranges. Add your insurance card to unlock Tier 2 plan pricing and Tier 3 verified benefit checks.
Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.
| Parkinson's Service / Medication | Self-Pay / Cash Price Hospital MRF / Retail Cash | Medicare Rate 2026 CMS / NADAC / Part D | Anthem Blue Cross MRF Negotiated / Formulary | Blue Shield of CA MRF Negotiated / Formulary | UnitedHealthcare MRF Negotiated / Formulary | Aetna MRF Negotiated / Formulary | Cigna MRF Negotiated / Formulary | Kaiser Permanente MRF Negotiated / Formulary | Medi-Cal (CA Medicaid) CA DHCS / Medi-Cal Rx |
|---|---|---|---|---|---|---|---|---|---|
Pathway ServiceCPT 99349 Home Health & Neuromuscular Rehab Visit (CPT 99349 / CPT 97112) | $63–$278 Self-pay discounted cash / negotiated spread ($18–$529 overall across 14 Bay Area hospitals) Source: 14 Bay Area Hospital MRFs (45 CFR § 180.50) Date: Oct 2026 | $178.5 CMS 2026 allowed rate (~$35.7 Part B 20% coinsurance; $0 with Medigap Plan G) Source: CMS CY 2026 Home Health Prospective Payment System (LUPA Per-Visit Rate) & MPFS (CPT 99349 Home Visit & CPT 97112 Neuromuscular Re-education) Date: CY 2026 (Jan 2026) | $40–$529 Negotiated across 6 Bay Area hospital MRFs (e.g., Stanford Hospital (Palo Alto): Blue Card (Out Of State) [40000] (Anthem Blue Cross) ($345); Stanford Hospital (Palo Alto): Blue Cross Medi-Cal [31100] (Anthem Blue Cross) ($345)) Source: Bay Area Hospital MRFs (6/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $52–$529 Negotiated across 4 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Shield (Medicare Managed Care Plan) ($52); Stanford Hospital (Palo Alto): American Specialty Health Plan Alt Payer [971000000] (Blue Shield) ($529)) Source: Bay Area Hospital MRFs (4/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $41–$471 Negotiated across 3 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Unitedhealthcare (Medicare Managed Care Plan) ($50); Stanford Hospital (Palo Alto): Uhc West Comm Alt Payer [913600000] (United Health Care) ($471)) Source: Bay Area Hospital MRFs (3/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $41–$417 Negotiated across 2 Bay Area hospital MRFs (e.g., Stanford Hospital (Palo Alto): Aetna [10200] (Aetna) ($417); Washington Hospital (Fremont): AETNA MCR ADV ($41)) Source: Bay Area Hospital MRFs (2/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $189–$276 Negotiated across 2 Bay Area hospital MRFs (e.g., Stanford Hospital (Palo Alto): Cigna [11000] (Cigna Hmo) ($219); Washington Hospital (Fremont): CIGNA NEW BUS OAP ($189)) Source: Bay Area Hospital MRFs (2/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $18–$319 Negotiated across 2 Bay Area hospital MRFs (e.g., Stanford Hospital (Palo Alto): Kaiser Northern Ca [12900] (Multiplan) ($319); Washington Hospital (Fremont): KAISER MCR ADV ($41)) Source: Bay Area Hospital MRFs (2/14 facilities, 45 CFR § 180.50) Date: 2026-10-01 | $0 patient copay Medi-Cal Fee-For-Service / Managed Care ($0 beneficiary cost-sharing; provider benchmark ~$143) Source: CA DHCS 2026 Medi-Cal Rates & Cost-Sharing Rules Date: Oct 2026 |
Every Insurance Cell for Home Health & Neuromuscular Rehab Visit (CPT 99349 / CPT 97112) — With Source & Date Citations
Self-Pay / Discounted Cash Price
Self-pay discounted cash / negotiated spread ($18–$529 overall across 14 Bay Area hospitals)
Original Medicare (CMS 2026 / NADAC / Part D)
CMS 2026 allowed rate (~$35.7 Part B 20% coinsurance; $0 with Medigap Plan G)
Anthem Blue Cross (California)
Negotiated across 6 Bay Area hospital MRFs (e.g., Stanford Hospital (Palo Alto): Blue Card (Out Of State) [40000] (Anthem Blue Cross) ($345); Stanford Hospital (Palo Alto): Blue Cross Medi-Cal [31100] (Anthem Blue Cross) ($345))
Blue Shield of California
Negotiated across 4 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Shield (Medicare Managed Care Plan) ($52); Stanford Hospital (Palo Alto): American Specialty Health Plan Alt Payer [971000000] (Blue Shield) ($529))
UnitedHealthcare (UHC)
Negotiated across 3 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Unitedhealthcare (Medicare Managed Care Plan) ($50); Stanford Hospital (Palo Alto): Uhc West Comm Alt Payer [913600000] (United Health Care) ($471))
Aetna
Negotiated across 2 Bay Area hospital MRFs (e.g., Stanford Hospital (Palo Alto): Aetna [10200] (Aetna) ($417); Washington Hospital (Fremont): AETNA MCR ADV ($41))
Cigna
Negotiated across 2 Bay Area hospital MRFs (e.g., Stanford Hospital (Palo Alto): Cigna [11000] (Cigna Hmo) ($219); Washington Hospital (Fremont): CIGNA NEW BUS OAP ($189))
Kaiser Permanente (Northern CA)
Negotiated across 2 Bay Area hospital MRFs (e.g., Stanford Hospital (Palo Alto): Kaiser Northern Ca [12900] (Multiplan) ($319); Washington Hospital (Fremont): KAISER MCR ADV ($41))
Medi-Cal (California Medicaid / Medi-Cal Rx)
Medi-Cal Fee-For-Service / Managed Care ($0 beneficiary cost-sharing; provider benchmark ~$143)
Hospital-by-Hospital Published Rates for Home Health & Neuromuscular Rehab Visit (CPT 99349 / CPT 97112)
| Bay Area Hospital | Self-Pay Cash Price | 2026 Medicare Rate | Negotiated Payer Min–Max | Audited Payer Families |
|---|---|---|---|---|
| UCSF Medical Center (SF) San Francisco • UCSF Health | $93 | $179 | $41–$83 | Medicare Advantage |
| Stanford Hospital (Palo Alto) Palo Alto • Stanford Medicine | $278 | $179 | $41–$529 | Aetna, Blue Shield of California, Anthem Blue Cross, Medi-Cal / County Managed Care, Cigna, Health Net, Kaiser Permanente, UnitedHealthcare, Medicare Advantage |
| Stanford Tri-Valley (Pleasanton) Pleasanton • Stanford Medicine | $76 | $179 | $119–$123 | Blue Shield of California |
| El Camino Health (Mountain View) Mountain View • El Camino Health | $63 | $179 | Not published | Standard MRF |
| Washington Hospital (Fremont) Fremont • Washington Township Health Care District | $198 | $179 | $18–$328 | Medicare Advantage, Medi-Cal / County Managed Care, Anthem Blue Cross, Blue Shield of California, Canopy Health, Health Net, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente |
| CPMC Van Ness (San Francisco) San Francisco • Sutter Health | $236 | $179 | Not published | Standard MRF |
| Alta Bates Medical Center (Berkeley) Berkeley • Sutter Health | $236 | $179 | $41–$41 | Medicare Advantage |
| Summit Medical Center (Oakland) Oakland • Sutter Health | $236 | $179 | $41–$41 | Medicare Advantage |
| Eden Medical Center (Castro Valley) Castro Valley • Sutter Health | $236 | $179 | Not published | Standard MRF |
| Mills-Peninsula (Burlingame) Burlingame • Sutter Health | $236 | $179 | $41–$41 | Medicare Advantage |
| Sutter Delta (Antioch) Antioch • Sutter Health | $236 | $179 | $41–$41 | Medicare Advantage |
| Novato Community Hospital (Marin) Novato • Sutter Health | $236 | $179 | Not published | Standard MRF |
| Sutter Santa Rosa Regional Santa Rosa • Sutter Health | $236 | $179 | $41–$41 | Medicare Advantage |
| Sutter Solano (Vallejo) Vallejo • Sutter Health | $247 | $179 | Not published | Standard MRF |