HCPCS code G0078: Home care management, new patient, 45 minutes2026 Medicare rate & RVUs in New Jersey
A 45-minute care-management home visit for a new patient, reported when the documented service matches the new-patient home-visit and time level.
Medicare pays $126.93–$130.92 for G0078 in the office in New Jersey, from Rest of New Jersey to Northern New Jersey. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What G0078 covers
G0078 represents a care-management home visit for a new patient, with 45 minutes as its time designation. The service takes place in the patient’s home and focuses on care-management work during the visit. It is distinct from an office encounter and from other home-visit levels that specify a different patient category or duration.
Report G0078 when the record supports the new-patient category, home setting, care-management service, and 45-minute level. Documentation should identify the care needs addressed, the work performed during the visit, and the time supporting the selected level. CMS assigns relative value units for physician work, practice expense, and malpractice; the practice-expense valuation includes office and facility settings.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where G0078 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | $130.92 | Unavailable |
| Rest of New Jersey | $126.93 | Unavailable |
How the G0078 rate is calculated
Each of G0078’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · G0078
RVUs × geographic indexes × conversion factor
Work2.53
2.53 RVUs× 1.000 GPCI
Practice expense0.95
0.95 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
3.6000
Conversion factor
$33.4009
Medicare rate
$120.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0078
G0078 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · G0078
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$120.24
Higher because the practice carries its own overhead.
G0078 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- G0077Home care managementNew patient, 30 minutes
- G0077 identifies a new-patient care-management home visit at the 30-minute level; G0078 identifies the 45-minute level.
- G0079Care management visitNew patient, 60 minutes
- Both are new-patient care-management home-visit levels. G0079 specifies 60 minutes rather than 45 minutes.
- G0083Care management visitEstablished patient, 45 minutes
- G0083 is the 45-minute level for an established patient. G0078 is for a new patient.
- G0086Care managementHome care plan, 30 minutes
- G0086 describes a care-management home-care-plan service with a 30-minute designation, rather than G0078’s new-patient home-visit level.
G0078 billing questions
How does G0078 differ from G0077?
Both describe new-patient care-management home visits, but G0077 is the 30-minute level and G0078 is the 45-minute level. Choose the level supported by the documented service time.
How does G0078 differ from G0083?
G0078 is for a new patient; G0083 is the 45-minute care-management home-visit level for an established patient.
What should the record show?
Document the home setting, the patient’s new-patient status, the care-management needs addressed, the work performed, and time supporting the 45-minute level.
Does G0078 describe an office visit?
No. Its descriptor identifies a care-management home visit. An office-based service does not match that setting.
Can G0078 be selected just because the appointment lasted 45 minutes?
The code also identifies a new-patient care-management home visit. The record should support the service type and patient category as well as the time level.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put G0078 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet