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

In Utah, Medicare pays $54.61 for G0180 in the office.

Check a contract rate as a % of Medicare · G0180 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 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.

How Utah compares for G0180

Across 109 of 109 payment localities, the office rate for G0180 runs from $51.26 in Arkansas to $73.16 in San Benito County, CA. Utah pays $54.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

G0180 rates by state

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

See G0180 in every payment locality

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.

Codes related to G0180

Related codes aren’t interchangeable: bill the code that matches the service performed.

How G0180 has changed in Utah

Price G0180 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

• Alpine
• Alta
• Altamont
• Alton
• Amalga
• American Fork
• Aneth
• Annabella

Browse all communities in Utah

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