HCPCS code G0162: RN plan management, per 15 minutes2026 Medicare rate & RVUs in Massachusetts
Reports RN management and evaluation of a home health or hospice plan of care when RN involvement is needed for essential non-skilled care.
CMS doesn’t publish an office rate for G0162 in Massachusetts.
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 G0162 covers
G0162 describes skilled registered-nurse services focused on managing and evaluating a home health or hospice plan of care. It applies when the patient’s underlying condition or a complication makes RN involvement necessary to ensure essential non-skilled care achieves its purpose. The service is furnished in the home health or hospice setting and concerns the RN’s role in the plan of care, rather than a specific hands-on nursing intervention.
Each billable unit represents 15 minutes of that RN service. CMS assigns physician fee schedule status E, excluding G0162 from the physician fee schedule by regulation. HCPCS pricing classifies it as not separately priced by Medicare Part B; when Medicare covers the service, payment is under another payment method. Medicare coverage is left to the contractor’s judgment.
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 G0162 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | Unavailable |
| Rest of Massachusetts | Unavailable | Unavailable |
How the G0162 rate is calculated
Each of G0162’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 · G0162
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0162
G0162 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 · G0162
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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G0162 isn’t priced in this setting.
G0162 compared with similar codes
Compare codes · National
G0162 vs G0299 vs G0181: Medicare rates
How to choose
- G0299RN nursingPer 15 minutes
- G0299 reports direct skilled nursing services by an RN. G0162 describes RN management and evaluation of the plan of care when RN involvement is needed for essential non-skilled care to achieve its purpose.
- G0181Home health supervision30 minutes per calendar month
- G0181 describes physician supervision of home health care. G0162 describes an RN’s management and evaluation of the patient’s plan of care.
G0162 billing questions
When should G0162 be used instead of G0299?
G0162 describes RN management and evaluation of the plan of care when RN involvement is needed for essential non-skilled care to achieve its purpose. G0299 describes direct skilled nursing services furnished by an RN.
Does G0162 represent a 15-minute unit?
Yes. Each unit represents 15 minutes of the qualifying RN management and evaluation service.
Can G0162 describe a physical therapy or aide service?
No. G0162 describes an RN service. G0151 and G0156 describe home health services furnished by other disciplines.
How does Medicare treat G0162 under the physician fee schedule?
CMS assigns status E, excluding the code from the physician fee schedule by regulation. HCPCS pricing classifies it as not separately priced by Medicare Part B; covered services are paid under another payment method.
Who determines Medicare coverage for G0162?
Coverage is left to the Medicare contractor’s judgment.
What should the record support when G0162 is reported?
The record should support the RN’s management and evaluation of the plan of care and the patient’s need for RN involvement so essential non-skilled care can achieve its purpose.
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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