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

Reports 30 minutes of care-management work focused on a patient's home care plan, rather than a timed care-management visit in the home.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Rhode Island, Medicare pays $75.20 for G0086 in the office.

$75.20Office (non-facility)
Not available in this settingHospital or facility
+1.9%vs the national office rate ($73.82)

Check a contract rate as a % of Medicare · G0086 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 G0086 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Rhode Island
  2. What G0086 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 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.

How Rhode Island compares for G0086

Across 109 of 109 payment localities, the office rate for G0086 runs from $68.15 in Arkansas to $95.06 in Alaska. Rhode Island pays $75.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0086 in Rhode Island vs other payment areas
  1. Rhode Island · this page$75.20
  2. Los Angeles, CA · California$79.66+$4.46
  3. Washington, DC area · District of Columbia$81.56+$6.36
  4. Miami, FL · Florida$80.10+$4.90
  5. Chicago, IL · Illinois$78.58+$3.38
  6. Manhattan, NY · New York$83.10+$7.90
  7. Alaska · Alaska$95.06+$19.86

Other areas in Rhode Island first, then benchmark localities. Bars start at $0.

Every other payment area

G0086 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$68.78—
ArkansasArkansas$68.15—
ArizonaArizona$72.44—
Bakersfield, CACalifornia$76.06—
Chico, CACalifornia$75.73—
El Centro, CACalifornia$75.75—
Fresno, CACalifornia$75.73—
Hanford, CACalifornia$75.73—

G0086 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.

$68.15

$95.06

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

View every state and territory as a table
G0086 office rate range by state
State / territoryOffice rate rangeLocalities
AK$95.061
AL$68.781
AR$68.151
AZ$72.441
CA$75.73–$89.5629
CO$75.421
CT$77.561
DC$81.561
DE$73.341
FL$74.23–$80.103
GA$71.36–$75.072
GU$76.351
HI$76.351
IA$69.361
ID$69.761
IL$73.20–$78.584
IN$70.001
KS$69.401
KY$70.341
LA$70.37–$72.582
MA$75.33–$80.732
MD$74.30–$81.563
ME$70.26–$72.322
MI$71.75–$75.102
MN$72.301
MO$69.77–$72.443
MS$68.951
MT$73.811
NC$70.691
ND$71.831
NE$69.531
NH$74.581
NJ$78.45–$81.272
NM$72.101
NV$73.291
NY$71.39–$84.785
OH$71.341
OK$70.001
OR$72.71–$76.822
PA$71.28–$76.392
PR$74.081
RI$75.201
SC$71.131
SD$71.601
TN$69.661
TX$70.99–$75.208
UT$71.751
VA$72.35–$81.562
VI$74.081
VT$71.881
WA$75.08–$81.812
WI$70.301
WV$71.491
WY$72.951

See G0086 in every payment locality

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.

How the rate is built · G0086

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.25

1.25 RVUs× 1.000 GPCI

Practice expense0.86

0.86 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

2.2100

Conversion factor

$33.4009

Medicare rate

$73.82

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

The exact Rhode Island inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,078

Code
G0086
Physician work
1.25
Practice expense
0.86
Malpractice
0.10

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Office calculation for G0086 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work1.25× 1.0191.2737
Practice expense0.86× 1.0330.8884
Malpractice0.10× 0.8920.0892
Total RVUs2.2513
Conversion factor× 33.4009

Office rate, Rhode Island$75.20

Office: (1.25 × 1.019 + 0.86 × 1.033 + 0.1 × 0.892) × $33.4009 = $75.20

Open G0086 in the RVU calculator

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.

Place of service · G0086

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$73.82

Higher because the practice carries its own overhead.

How G0086 has changed in Rhode Island

G0086 · Office / nonfacility

$75.20

Effective 2026-10-01

The base rate is $1.77 higher than on 2025-10-01, moving from $73.43 to $75.20 (2.4%).

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

    $73.43changed to$75.20

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.87 changed to 0.86
    • Work GPCI 1.025 changed to 1.019
    • Practice expense GPCI 1.039 changed to 1.033
    • Malpractice GPCI 0.849 changed to 0.892

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $75.57changed to$73.43

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $74.33changed to$75.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $77.21changed to$74.33

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.023 changed to 1.025
    • Practice expense GPCI 1.044 changed to 1.039
    • Malpractice GPCI 0.915 changed to 0.849
  5. January 1, 2023

    RVU23A

    $79.11changed to$77.21

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.021 changed to 1.023
    • Practice expense GPCI 1.048 changed to 1.044
    • Malpractice GPCI 0.981 changed to 0.915

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $79.77changed to$79.11

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $81.59changed to$79.77

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.85 changed to 0.87
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.024 changed to 1.021
    • Practice expense GPCI 1.049 changed to 1.048
    • Malpractice GPCI 0.990 changed to 0.981

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $80.95changed to$81.59

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.07 changed to 0.09
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.050 changed to 1.049
    • Malpractice GPCI 0.999 changed to 0.990

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$80.95

    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$75.20Not available in this settingRVU26D
2026-07-01$75.20Not available in this settingRVU26C
2026-04-01$75.20Not available in this settingRVU26B
2026-01-01$75.20Not available in this settingRVU26A
2025-10-01$73.43Not available in this settingRVU25D
2025-07-01$73.43Not available in this settingRVU25C
2025-04-01$73.43Not available in this settingRVU25B
2025-01-01$73.43Not available in this settingRVU25A
2024-10-01$75.57Not available in this settingRVU24D
2024-07-01$75.57Not available in this settingRVU24C
2024-04-01$75.57Not available in this settingRVU24B
2024-03-09$75.57Not available in this settingRVU24AR
2024-01-01$74.33Not available in this settingRVU24A
2023-10-01$77.21Not available in this settingRVU23D
2023-07-01$77.21Not available in this settingRVU23C
2023-04-01$77.21Not available in this settingRVU23B
2023-01-01$77.21Not available in this settingRVU23A
2022-10-01$79.11Not available in this settingRVU22D
2022-07-01$79.11Not available in this settingRVU22C
2022-04-01$79.11Not available in this settingRVU22B
2022-01-01$79.11Not available in this settingRVU22A
2021-10-01$79.77Not available in this settingRVU21D
2021-07-01$79.77Not available in this settingRVU21C
2021-04-01$79.77Not available in this settingRVU21B
2021-01-01$79.77Not available in this settingRVU21A
2020-10-01$81.59Not available in this settingRVU20D
2020-07-01$81.59Not available in this settingRVU20C
2020-04-01$81.59Not available in this settingRVU20B
2020-01-01$81.59Not available in this settingRVU20A
2019-10-01$80.95Not available in this settingRVU19D
2019-07-01$80.95Not available in this settingRVU19C
2019-04-01$80.95Not available in this settingRVU19B
2019-01-01$80.95Not 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 G0086 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

G0086 billing questions

How does G0086 differ from a home-visit care-management code?

G0086 is for time spent managing a home care plan. G0077 and G0082 describe timed home visits for new and established patients, respectively.

When should the 30-minute code be selected?

Select G0086 when the documented service is plan-focused care management and supports its 30-minute interval. Do not select it just because care relates to a patient who receives services at home.

What documentation supports G0086?

Document the time spent, the patient's home care plan, and the specific review, coordination, or plan-management work performed.

How does G0086 differ from G0087?

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

Is G0086 reported for an in-home patient encounter?

The code represents plan-management work, not a timed home visit. Use the home-visit code family when the service is a qualifying care-management visit.

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 G0086PPRRVU2026_Oct_nonQPP.csv, line 15,078 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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