HCPCS code G0080: Home care management, new patient, 75 minutes2026 Medicare rate & RVUs in Michigan
Reports a 75-minute, new-patient care-management visit delivered at home, with time and coordination work documented for the encounter.
Medicare pays $211.91–$220.31 for G0080 in the office in Michigan, from Rest of Michigan to Detroit, MI. 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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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 in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $220.31 | Unavailable |
| Rest of Michigan | $211.91 | Unavailable |
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
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.
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.
G0080 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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