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

Reports a 75-minute, new-patient care-management visit delivered at home, with time and coordination work documented for the encounter.

CMS RVU26DEffective Oct 1, 2026One payment locality11 Medicare services in 2024

In Washington, DC area, Medicare pays $238.27 for G0080 in the office.

$238.27Office (non-facility)
Not available in this settingHospital or facility
+9.7%vs the national office rate ($217.11)

Check a contract rate as a % of Medicare · G0080 nationwide

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

We’ll open G0080 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What G0080 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Washington, DC area compares for G0080

Across 109 of 109 payment localities, the office rate for G0080 runs from $202.88 in Arkansas to $286.35 in Alaska. Washington, DC area pays $238.27. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0080 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$238.27
  2. Los Angeles, CA · California$233.10−$5.17
  3. Miami, FL · Florida$232.83−$5.44
  4. Chicago, IL · Illinois$229.24−$9.03
  5. Manhattan, NY · New York$242.43+$4.16
  6. Alaska · Alaska$286.35+$48.08
  7. Alabama · Alabama$204.46−$33.81

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

G0080 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$202.88—
ArizonaArizona$213.67—
Bakersfield, CACalifornia$223.36—
Chico, CACalifornia$222.48—
El Centro, CACalifornia$222.52—
Fresno, CACalifornia$222.48—
Hanford, CACalifornia$222.48—
Madera, CACalifornia$222.48—

G0080 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$202.88

$286.35

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
G0080 office rate range by state
State / territoryOffice rate rangeLocalities
AK$286.351
AL$204.461
AR$202.881
AZ$213.671
CA$222.48–$260.1529
CO$221.531
CT$227.151
DC$238.271
DE$216.081
FL$218.13–$232.833
GA$210.92–$220.352
GU$223.471
HI$223.471
IA$205.941
ID$206.931
IL$215.53–$229.244
IN$207.551
KS$206.041
KY$208.391
LA$208.46–$213.982
MA$221.42–$235.782
MD$218.65–$238.273
ME$208.18–$213.382
MI$211.91–$220.312
MN$213.321
MO$206.93–$213.663
MS$204.901
MT$217.091
NC$209.261
ND$212.151
NE$206.361
NH$219.021
NJ$230.02–$237.822
NM$212.801
NV$215.781
NY$211.02–$246.645
OH$210.901
OK$207.521
OR$214.34–$225.162
PA$210.73–$224.132
PR$217.771
RI$221.181
SC$210.371
SD$211.561
TN$206.671
TX$210.02–$220.838
UT$211.931
VA$213.42–$238.272
VI$217.771
VT$212.261
WA$220.71–$238.792
WI$208.301
WV$211.251
WY$214.931

See G0080 in every payment locality

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.

How the rate is built · G0080

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.09

4.09 RVUs× 1.000 GPCI

Practice expense2.16

2.16 RVUs× 1.000 GPCI

Malpractice0.25

0.25 RVUs× 1.000 GPCI

Adjusted RVUs

6.5000

Conversion factor

$33.4009

Medicare rate

$217.11

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,072

Code
G0080
Physician work
4.09
Practice expense
2.16
Malpractice
0.25

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for G0080 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work4.09× 1.0544.3109
Practice expense2.16× 1.1782.5445
Malpractice0.25× 1.1130.2782
Total RVUs7.1336
Conversion factor× 33.4009

Office rate, Washington, DC area$238.27

Office: (4.09 × 1.054 + 2.16 × 1.178 + 0.25 × 1.113) × $33.4009 = $238.27

Open G0080 in the RVU calculator

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.

Place of service · G0080

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$217.11

Higher because the practice carries its own overhead.

How G0080 has changed in Washington, DC area

G0080 · Office / nonfacility

$238.27

Effective 2026-10-01

The base rate is $17.27 higher than on 2025-10-01, moving from $221.00 to $238.27 (7.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $221.00changed to$238.27

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.86 changed to 2.16
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $228.22changed to$221.00

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.88 changed to 1.86

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $224.50changed to$228.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $232.90changed to$224.50

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.85 changed to 1.88
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $244.27changed to$232.90

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.93 changed to 1.85
    • Malpractice RVU 0.28 changed to 0.25
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $247.22changed to$244.27

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.92 changed to 1.93
    • Malpractice RVU 0.31 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $253.31changed to$247.22

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.90 changed to 1.92
    • Malpractice RVU 0.32 changed to 0.31
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $246.58changed to$253.31

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.88 changed to 1.90
    • Malpractice RVU 0.24 changed to 0.32
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$246.58

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$238.27Not available in this settingRVU26D
2026-07-01$238.27Not available in this settingRVU26C
2026-04-01$238.27Not available in this settingRVU26B
2026-01-01$238.27Not available in this settingRVU26A
2025-10-01$221.00Not available in this settingRVU25D
2025-07-01$221.00Not available in this settingRVU25C
2025-04-01$221.00Not available in this settingRVU25B
2025-01-01$221.00Not available in this settingRVU25A
2024-10-01$228.22Not available in this settingRVU24D
2024-07-01$228.22Not available in this settingRVU24C
2024-04-01$228.22Not available in this settingRVU24B
2024-03-09$228.22Not available in this settingRVU24AR
2024-01-01$224.50Not available in this settingRVU24A
2023-10-01$232.90Not available in this settingRVU23D
2023-07-01$232.90Not available in this settingRVU23C
2023-04-01$232.90Not available in this settingRVU23B
2023-01-01$232.90Not available in this settingRVU23A
2022-10-01$244.27Not available in this settingRVU22D
2022-07-01$244.27Not available in this settingRVU22C
2022-04-01$244.27Not available in this settingRVU22B
2022-01-01$244.27Not available in this settingRVU22A
2021-10-01$247.22Not available in this settingRVU21D
2021-07-01$247.22Not available in this settingRVU21C
2021-04-01$247.22Not available in this settingRVU21B
2021-01-01$247.22Not available in this settingRVU21A
2020-10-01$253.31Not available in this settingRVU20D
2020-07-01$253.31Not available in this settingRVU20C
2020-04-01$253.31Not available in this settingRVU20B
2020-01-01$253.31Not available in this settingRVU20A
2019-10-01$246.58Not available in this settingRVU19D
2019-07-01$246.58Not available in this settingRVU19C
2019-04-01$246.58Not available in this settingRVU19B
2019-01-01$246.58Not available in this settingRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price G0080 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

G0080 billing questions

How does G0080 differ from G0079?

Both are new-patient home care-management tiers. G0079 represents the 60-minute level; G0080 is the 75-minute level.

Can G0080 be used for an established patient?

No. G0080 is the new-patient tier; G0085 is the 75-minute home care-management code for an established patient.

What documentation supports G0080?

Document the patient’s new-patient status, home setting, time for the encounter, care needs addressed, coordination performed, and follow-up plan.

Is G0080 the same as a home E/M visit?

No. G0080 identifies timed home care management. A home or residence E/M code, such as 99345, describes an E/M service selected under its own criteria.

How is G0080 different from G0086?

G0080 is the new-patient, 75-minute home care-management visit tier. G0086 describes a timed home care-plan service.

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
RVUs for G0080PPRRVU2026_Oct_nonQPP.csv, line 15,072 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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