HCPCS code G0080: Home care management, new patient, 75 minutes2026 Medicare rate & RVUs

Medicare pays $217.11 for G0080 nationally in the office. Local office rates run $202.88–$286.35.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What G0080 covers

G0080 represents a new-patient care-management visit delivered in the patient’s home, at the 75-minute level. The encounter focuses on understanding care needs and coordinating next steps across the patient’s clinicians and home-based services. A physician or other practitioner furnishing the care-management service may report it for work performed in the home setting.

Choose G0080 when the documented service belongs to the 75-minute new-patient tier; G0076 through G0079 identify shorter new-patient tiers, while G0081 through G0085 are for established patients. The record should establish new-patient status, that the service occurred at home, time attributable to the encounter, care issues addressed, coordination performed, and the follow-up plan. CMS assigns physician work, practice-expense, and malpractice relative value units to the service in the physician fee schedule.

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 G0080 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

G0080 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the G0080 rate is calculated

Each of G0080’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.

Payment rules and modifiers for G0080

G0080 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.

G0080 compared with similar codes

How to choose

G0079Care management visitNew patient, 60 minutes

G0079 is the 60-minute new-patient home care-management tier; G0080 is the 75-minute tier.

G0085Care management visitEstablished patient, 75 minutes

Both identify the 75-minute home care-management level, but G0085 is for established patients and G0080 is for new patients.

G0086Care managementHome care plan, 30 minutes

G0086 describes a timed home care-plan service, rather than the new-patient 75-minute home visit represented by G0080.

99345Home visitNew patient, high complexity

99345 is a home or residence E/M service selected under E/M criteria. G0080 identifies a timed care-management visit.

Codes related to G0080

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates