HCPCS code G0079: Care management visit, new patient, 60 minutes2026 Medicare rate & RVUs in Texas
Reports a 60-minute care management visit in the patient's home for a new patient when the documented service and duration match this code.
Medicare pays $159.20–$166.26 for G0079 in the office in Texas, from Beaumont, TX to Houston, TX. 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.
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On this page 9 sections
What G0079 covers
G0079 identifies a care-management home visit for a new patient, with a 60-minute service duration. It describes work delivered during a visit in the patient's residence, rather than a routine office encounter. The descriptor does not specify a diagnosis, particular disease, or required discipline; the record should explain what care-management work was performed and why the visit took place at home.
Select this code when the patient meets the applicable new-patient definition and the documented visit duration matches the 60-minute level, rather than an adjacent duration level. Document the home setting, new-patient status, duration, and the care-management activities performed. CMS assigns work, practice-expense, and malpractice relative value units to the service; those resource inputs inform physician fee schedule payment.
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 G0079 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$159.20 to $166.26
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $165.92 | Unavailable |
| Beaumont, TX | $159.20 | Unavailable |
| Brazoria, TX | $162.98 | Unavailable |
| Dallas, TX | $163.74 | Unavailable |
| Fort Worth, TX | $163.36 | Unavailable |
| Galveston, TX | $163.33 | Unavailable |
| Houston, TX | $166.26 | Unavailable |
| Rest of Texas | $160.83 | Unavailable |
How the G0079 rate is calculated
Each of G0079’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 · G0079
RVUs × geographic indexes × conversion factor
Work3.38
3.38 RVUs× 1.000 GPCI
Practice expense1.36
1.36 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
4.9000
Conversion factor
$33.4009
Medicare rate
$163.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0079
G0079 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 · G0079
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$163.66
Higher because the practice carries its own overhead.
G0079 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- G0078Home care managementNew patient, 45 minutes
- Both are new-patient care-management home visits; G0078 is the 45-minute level, while G0079 is the 60-minute level.
- G0080Home care managementNew patient, 75 minutes
- Both describe new-patient care-management home visits; G0080 is the 75-minute level, while G0079 is the 60-minute level.
- G0084Home care managementEstablished patient, 60 minutes
- G0084 is the 60-minute care-management home visit for an established patient. G0079 is the corresponding new-patient level.
- G0087Care managementHome care plan, 60 minutes
- G0087 describes a 60-minute home care-plan service. G0079 describes a 60-minute new-patient care-management home visit.
G0079 billing questions
How does G0079 differ from G0078 and G0080?
These codes describe new-patient care-management home visits at different duration levels. G0078 is the 45-minute level, G0079 is 60 minutes, and G0080 is 75 minutes.
Does established-patient status change the code?
Yes. G0084 is the established-patient home-visit code at the 60-minute level; G0079 is for a new patient.
What documentation supports G0079?
Document the patient's new-patient status, that the service occurred at home, the visit duration, and the care-management work performed.
Is a care-plan service the same as this home visit?
No. G0079 describes a timed new-patient care-management home visit. G0086 and G0087 identify home care-plan services at different durations.
Does G0079 establish separate payment for other work?
The code identifies the 60-minute care-management home visit. Its descriptor alone does not establish separate reporting or payment for other services performed during the encounter.
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
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