HCPCS code G0085: Care management visit, established patient, 75 minutes2026 Medicare rate & RVUs in New Mexico
Reports a 75-minute care-management home visit for an established patient, distinguished from shorter visit levels and the corresponding new-patient service.
In New Mexico, Medicare pays $212.80 for G0085 in the office.
Check a contract rate as a % of Medicare · G0085 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What G0085 covers
G0085 represents an extended care-management visit in an established patient’s home. The clinician addresses the patient’s ongoing care needs during the home encounter. The code identifies both the established-patient status and the 75-minute service level; it differs from the new-patient home-visit level and from a home-care-plan service. The related established-patient visit codes describe shorter time levels.
Report G0085 when the patient is established, the service is a home visit for care management, and the documented time supports this level. Documentation should identify the patient’s status, the home setting, the care-management work performed, and the time associated with the visit. CMS values the service in the Physician Fee Schedule using physician-work, practice-expense, and malpractice RVUs.
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 New Mexico compares for G0085
Across 109 of 109 payment localities, the office rate for G0085 runs from $202.88 in Arkansas to $286.35 in Alaska. New Mexico pays $212.80. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$212.80
- Los Angeles, CA · California$233.10+$20.30
- Washington, DC area · District of Columbia$238.27+$25.47
- Miami, FL · Florida$232.83+$20.03
- Chicago, IL · Illinois$229.24+$16.44
- Manhattan, NY · New York$242.43+$29.63
- Alaska · Alaska$286.35+$73.55
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $204.46 | — |
| 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 | — |
| Merced, CACalifornia | $222.48 | — |
| Modesto, CACalifornia | $222.48 | — |
| Napa, CACalifornia | $244.55 | — |
| Oxnard, CACalifornia | $230.91 | — |
| Redding, CACalifornia | $222.48 | — |
| Rest of CaliforniaCalifornia | $222.48 | — |
| Riverside, CACalifornia | $225.26 | — |
| Sacramento, CACalifornia | $229.91 | — |
| Salinas, CACalifornia | $228.94 | — |
| San Diego, CACalifornia | $231.52 | — |
| Marin County, CACalifornia | $255.15 | — |
| San Francisco, CACalifornia | $254.86 | — |
| San Benito County, CACalifornia | $260.15 | — |
| Santa Clara County, CACalifornia | $258.99 | — |
| San Luis Obispo, CACalifornia | $225.58 | — |
| Santa Cruz, CACalifornia | $231.61 | — |
| Santa Maria, CACalifornia | $229.03 | — |
| Santa Rosa, CACalifornia | $233.78 | — |
| Stockton, CACalifornia | $222.48 | — |
| Vallejo, CACalifornia | $244.14 | — |
| Visalia, CACalifornia | $222.48 | — |
| Yuba City, CACalifornia | $222.48 | — |
| ColoradoColorado | $221.53 | — |
| ConnecticutConnecticut | $227.15 | — |
| DelawareDelaware | $216.08 | — |
| Fort Lauderdale, FLFlorida | $224.79 | — |
| Rest of FloridaFlorida | $218.13 | — |
| Atlanta, GAGeorgia | $220.35 | — |
| Rest of GeorgiaGeorgia | $210.92 | — |
| Hawaii, Guam, HIHawaii | $223.47 | — |
| IowaIowa | $205.94 | — |
| IdahoIdaho | $206.93 | — |
| East St. Louis, ILIllinois | $219.80 | — |
| Rest of IllinoisIllinois | $215.53 | — |
| Suburban Chicago, ILIllinois | $226.46 | — |
| IndianaIndiana | $207.55 | — |
| KansasKansas | $206.04 | — |
| KentuckyKentucky | $208.39 | — |
| New Orleans, LALouisiana | $213.98 | — |
| Rest of LouisianaLouisiana | $208.46 | — |
| Metropolitan Boston, MAMassachusetts | $235.78 | — |
| Rest of MassachusettsMassachusetts | $221.42 | — |
| Baltimore area, MDMaryland | $226.54 | — |
| Rest of MarylandMaryland | $218.65 | — |
| Rest of MaineMaine | $208.18 | — |
| Southern Maine, MEMaine | $213.38 | — |
| Detroit, MIMichigan | $220.31 | — |
| Rest of MichiganMichigan | $211.91 | — |
| MinnesotaMinnesota | $213.32 | — |
| Metropolitan Kansas City, MOMissouri | $212.51 | — |
| Metropolitan St. Louis, MOMissouri | $213.66 | — |
| Rest of MissouriMissouri | $206.93 | — |
| MississippiMississippi | $204.90 | — |
| MontanaMontana | $217.09 | — |
| North CarolinaNorth Carolina | $209.26 | — |
| North DakotaNorth Dakota | $212.15 | — |
| NebraskaNebraska | $206.36 | — |
| New HampshireNew Hampshire | $219.02 | — |
| Northern New JerseyNew Jersey | $237.82 | — |
| Rest of New JerseyNew Jersey | $230.02 | — |
| NevadaNevada | $215.78 | — |
| NYC suburbs and Long Island, NYNew York | $246.64 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $231.86 | — |
| Queens, NYNew York | $242.67 | — |
| Rest of New YorkNew York | $211.02 | — |
| OhioOhio | $210.90 | — |
| OklahomaOklahoma | $207.52 | — |
| Portland, OROregon | $225.16 | — |
| Rest of OregonOregon | $214.34 | — |
| Metropolitan Philadelphia, PAPennsylvania | $224.13 | — |
| Rest of PennsylvaniaPennsylvania | $210.73 | — |
| Puerto RicoPuerto Rico | $217.77 | — |
| Rhode IslandRhode Island | $221.18 | — |
| South CarolinaSouth Carolina | $210.37 | — |
| South DakotaSouth Dakota | $211.56 | — |
| TennesseeTennessee | $206.67 | — |
| Austin, TXTexas | $220.61 | — |
| Beaumont, TXTexas | $210.02 | — |
| Brazoria, TXTexas | $215.71 | — |
| Dallas, TXTexas | $216.86 | — |
| Fort Worth, TXTexas | $216.25 | — |
| Galveston, TXTexas | $216.26 | — |
| Houston, TXTexas | $220.83 | — |
| Rest of TexasTexas | $212.62 | — |
| UtahUtah | $211.93 | — |
| VirginiaVirginia | $213.42 | — |
| Virgin Islands, VIUnited States Virgin Islands | $217.77 | — |
| VermontVermont | $212.26 | — |
| Rest of WashingtonWashington | $220.71 | — |
| King County, WAWashington | $238.79 | — |
| WisconsinWisconsin | $208.30 | — |
| West VirginiaWest Virginia | $211.25 | — |
| WyomingWyoming | $214.93 | — |
G0085 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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $286.35 | 1 |
| AL | $204.46 | 1 |
| AR | $202.88 | 1 |
| AZ | $213.67 | 1 |
| CA | $222.48–$260.15 | 29 |
| CO | $221.53 | 1 |
| CT | $227.15 | 1 |
| DC | $238.27 | 1 |
| DE | $216.08 | 1 |
| FL | $218.13–$232.83 | 3 |
| GA | $210.92–$220.35 | 2 |
| GU | $223.47 | 1 |
| HI | $223.47 | 1 |
| IA | $205.94 | 1 |
| ID | $206.93 | 1 |
| IL | $215.53–$229.24 | 4 |
| IN | $207.55 | 1 |
| KS | $206.04 | 1 |
| KY | $208.39 | 1 |
| LA | $208.46–$213.98 | 2 |
| MA | $221.42–$235.78 | 2 |
| MD | $218.65–$238.27 | 3 |
| ME | $208.18–$213.38 | 2 |
| MI | $211.91–$220.31 | 2 |
| MN | $213.32 | 1 |
| MO | $206.93–$213.66 | 3 |
| MS | $204.90 | 1 |
| MT | $217.09 | 1 |
| NC | $209.26 | 1 |
| ND | $212.15 | 1 |
| NE | $206.36 | 1 |
| NH | $219.02 | 1 |
| NJ | $230.02–$237.82 | 2 |
| NM | $212.80 | 1 |
| NV | $215.78 | 1 |
| NY | $211.02–$246.64 | 5 |
| OH | $210.90 | 1 |
| OK | $207.52 | 1 |
| OR | $214.34–$225.16 | 2 |
| PA | $210.73–$224.13 | 2 |
| PR | $217.77 | 1 |
| RI | $221.18 | 1 |
| SC | $210.37 | 1 |
| SD | $211.56 | 1 |
| TN | $206.67 | 1 |
| TX | $210.02–$220.83 | 8 |
| UT | $211.93 | 1 |
| VA | $213.42–$238.27 | 2 |
| VI | $217.77 | 1 |
| VT | $212.26 | 1 |
| WA | $220.71–$238.79 | 2 |
| WI | $208.30 | 1 |
| WV | $211.25 | 1 |
| WY | $214.93 | 1 |
How the G0085 rate is calculated
Each of G0085’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 · G0085
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.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
15,077
- Code
- G0085
- Physician work
- 4.09
- Practice expense
- 2.16
- Malpractice
- 0.25
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.09 | × 1.000 | 4.0900 |
| Practice expense | 2.16 | × 0.917 | 1.9807 |
| Malpractice | 0.25 | × 1.201 | 0.3003 |
| Total RVUs | 6.3710 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$212.80
Office: (4.09 × 1 + 2.16 × 0.917 + 0.25 × 1.201) × $33.4009 = $212.80
Payment rules and modifiers for G0085
G0085 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 · G0085
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 G0085 has changed in New Mexico
G0085 · Office / nonfacility
$212.80
Effective 2026-10-01
The base rate is $16.40 higher than on 2025-10-01, moving from $196.40 to $212.80 (8.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$196.40changed to$212.80
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.86 changed to 2.16
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$202.72changed to$196.40
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.88 changed to 1.86
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$199.41changed to$202.72
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$205.05changed to$199.41
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.85 changed to 1.88
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$212.68changed to$205.05
- 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
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$215.35changed to$212.68
- 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.
January 1, 2021
RVU21A
$223.81changed to$215.35
- 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
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$220.59changed to$223.81
- 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
- Practice expense GPCI 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$220.59
Held through RVU19B, RVU19C, RVU19D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $212.80 | Not available in this setting | RVU26D |
| 2026-07-01 | $212.80 | Not available in this setting | RVU26C |
| 2026-04-01 | $212.80 | Not available in this setting | RVU26B |
| 2026-01-01 | $212.80 | Not available in this setting | RVU26A |
| 2025-10-01 | $196.40 | Not available in this setting | RVU25D |
| 2025-07-01 | $196.40 | Not available in this setting | RVU25C |
| 2025-04-01 | $196.40 | Not available in this setting | RVU25B |
| 2025-01-01 | $196.40 | Not available in this setting | RVU25A |
| 2024-10-01 | $202.72 | Not available in this setting | RVU24D |
| 2024-07-01 | $202.72 | Not available in this setting | RVU24C |
| 2024-04-01 | $202.72 | Not available in this setting | RVU24B |
| 2024-03-09 | $202.72 | Not available in this setting | RVU24AR |
| 2024-01-01 | $199.41 | Not available in this setting | RVU24A |
| 2023-10-01 | $205.05 | Not available in this setting | RVU23D |
| 2023-07-01 | $205.05 | Not available in this setting | RVU23C |
| 2023-04-01 | $205.05 | Not available in this setting | RVU23B |
| 2023-01-01 | $205.05 | Not available in this setting | RVU23A |
| 2022-10-01 | $212.68 | Not available in this setting | RVU22D |
| 2022-07-01 | $212.68 | Not available in this setting | RVU22C |
| 2022-04-01 | $212.68 | Not available in this setting | RVU22B |
| 2022-01-01 | $212.68 | Not available in this setting | RVU22A |
| 2021-10-01 | $215.35 | Not available in this setting | RVU21D |
| 2021-07-01 | $215.35 | Not available in this setting | RVU21C |
| 2021-04-01 | $215.35 | Not available in this setting | RVU21B |
| 2021-01-01 | $215.35 | Not available in this setting | RVU21A |
| 2020-10-01 | $223.81 | Not available in this setting | RVU20D |
| 2020-07-01 | $223.81 | Not available in this setting | RVU20C |
| 2020-04-01 | $223.81 | Not available in this setting | RVU20B |
| 2020-01-01 | $223.81 | Not available in this setting | RVU20A |
| 2019-10-01 | $220.59 | Not available in this setting | RVU19D |
| 2019-07-01 | $220.59 | Not available in this setting | RVU19C |
| 2019-04-01 | $220.59 | Not available in this setting | RVU19B |
| 2019-01-01 | $220.59 | Not available in this setting | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
G0085 billing questions
How does G0085 differ from G0084?
Both describe care-management home visits for established patients. G0085 is the 75-minute level; G0084 is the 60-minute level.
Can G0085 be used for a new patient?
No. G0085 is the established-patient level. G0080 is the corresponding 75-minute home-visit level for a new patient.
What time should the documentation support?
The record should support the 75-minute service level and describe the care-management work performed during the home visit.
How is G0085 different from G0086?
G0085 describes an established-patient care-management home visit. G0086 describes a home care plan service at the 30-minute 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 · Coming soon
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