HCPCS code G0180: Home health certification, initial certification, patient not present2026 Medicare rate & RVUs

Medicare pays $56.78 for G0180 nationally in the office. Local office rates run $51.26–$73.16.

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

What G0180 covers

G0180 covers the non-face-to-face work of a physician or other eligible practitioner initially certifying a patient for Medicare-covered home health services. The practitioner reviews the proposed plan of care and information from the home health agency, establishes that the patient is homebound and needs qualifying skilled care, and signs the certification. Primary care physicians and hospitalists arranging home health after discharge commonly perform this work; eligible nurse practitioners, clinical nurse specialists, and physician assistants may also certify.

Report G0180 for an initial certification, generally when the patient has received no Medicare home health services in the preceding 60 days. Use G0179 to recertify an ongoing plan for a later certification period. The record should support homebound status and skilled need, include the signed certification and plan of care, and document a qualifying face-to-face encounter within the required window around the start of care. A separately performed face-to-face visit is reported under its own visit code; its work is not the certification service. Keep certification work distinct from any time counted toward monthly home health care plan oversight under G0181.

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 G0180 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

G0180 rates by state

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

How the G0180 rate is calculated

Each of G0180’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 G0180

G0180 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.

G0180 compared with similar codes

How to choose

G0179Home healthRecertification

G0180 is for initial home health certification; G0179 recertifies an ongoing plan for a later certification period. Do not report both for the same certification period.

G0181Home health supervision30 minutes per calendar month

G0181 requires at least 30 minutes of qualifying home health care plan oversight in a calendar month. G0180 is reported for initial certification work, not for accumulated oversight minutes.

G0162RN plan managementPer 15 minutes

G0162 describes a home health registered nurse’s management and evaluation of the care plan. G0180 describes the certifying practitioner’s initial Medicare home health certification.

Codes related to G0180

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