HCPCS code G0155: Social work, home health or hospice2026 Medicare rate & RVUs in Puerto Rico

CMS doesn’t publish a rate for G0155 in Puerto Rico.

Check a contract rate as a % of Medicare · G0155 nationwide

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

What G0155 covers

G0155 represents clinical social work in a home health or hospice setting. A clinical social worker may address a patient’s psychosocial needs, coping with illness, family or caregiver concerns, and connection to community resources. The home health agency or hospice reports the service when its clinical social worker provides care in that setting; this is distinct from physical, occupational, or speech-language therapy and aide services.

Medicare assigns G0155 status X, meaning the physician fee schedule does not pay it because it is not a physician service under the Medicare statute. It is not separately priced by Medicare Part B; when covered, payment is through another fee schedule or payment system. Coverage is left to the Medicare contractor’s judgment. The code represents each 15 minutes of service.

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 Puerto Rico compares for G0155

Every other payment area

G0155 rates by state

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

See G0155 in every payment locality

How the G0155 rate is calculated

Each of G0155’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 G0155

G0155 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.

How G0155 has changed in Puerto Rico

Price G0155 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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