HCPCS code G0086: Care management, home care plan, 30 minutes2026 Medicare rate & RVUs

Medicare pays $73.82 for G0086 nationally in the office. Local office rates run $68.15–$95.06.

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

What G0086 covers

G0086 represents care-management work directed at a patient's home care plan for a 30-minute service interval. The work may include reviewing the patient's status, coordinating information about care, and managing the plan as needs change. A physician or other qualified health care professional overseeing the patient's care may perform this work in a practice or other setting; the code describes plan-focused management, not a home visit.

Choose G0086 when the documented service is management of the home care plan and supports the 30-minute code, rather than a timed new- or established-patient home visit. Record the time and the plan-related work performed, such as review, coordination, and resulting care-plan actions. The record should make clear how the work relates to the patient's home care plan.

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 G0086 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

G0086 rates by state

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

How the G0086 rate is calculated

Each of G0086’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 G0086

G0086 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.

G0086 compared with similar codes

How to choose

G0087Care managementHome care plan, 60 minutes

Both address management of a home care plan. G0086 is the 30-minute code; G0087 is the 60-minute code.

G0077Home care managementNew patient, 30 minutes

G0077 describes a 30-minute care-management home visit for a new patient. G0086 describes plan-management work rather than the home visit.

G0082Care managementEstablished patient, 30 minutes

G0082 describes a 30-minute care-management home visit for an established patient. G0086 is for management of the home care plan, not the visit.

Codes related to G0086

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