HCPCS code G0296: LDCT counseling, eligibility and shared decision-making2026 Medicare rate & RVUs in Kentucky

Report G0296 for the face-to-face visit that assesses Medicare lung cancer screening eligibility and supports a shared decision about low-dose CT screening.

CMS RVU26DEffective Oct 1, 2026One payment locality69.1K Medicare services in 2024

In Kentucky, Medicare pays $27.49 for G0296 in the office and $21.85 when it’s performed in a hospital or facility.

$27.49Office (non-facility)
$21.85Hospital or facility
−4.3%vs the national office rate ($28.72)

Check a contract rate as a % of Medicare · G0296 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 G0296 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What G0296 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 G0296 covers

G0296 represents a face-to-face counseling and shared decision-making visit to determine whether a patient should undergo lung cancer screening with low-dose CT (LDCT). A physician or qualified nonphysician practitioner typically conducts the visit in an office or outpatient setting. The patient must be asymptomatic and meet Medicare screening criteria, including age 50 through 77, at least a 20 pack-year smoking history, and current smoking or quitting within the past 15 years. The discussion addresses screening benefits and harms, the importance of annual adherence, the effect of comorbidities, and willingness to pursue evaluation and treatment if needed.

Report G0296 for the eligibility and decision visit, not for image acquisition; report 71271 for the screening CT. Documentation should support the patient’s age and smoking history, absence of lung cancer symptoms, eligibility assessment, use of a decision aid, and shared decision-making discussion. Include documentation of smoking cessation or abstinence counseling as appropriate. The code is associated with the initial screening decision visit before the first LDCT; it does not describe the scan itself.

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 Kentucky compares for G0296

Across 109 of 109 payment localities, the office rate for G0296 runs from $26.78 in Arkansas to $37.63 in Alaska. Kentucky pays $27.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0296 in Kentucky vs other payment areas
  1. Kentucky · this page$27.49
  2. Los Angeles, CA · California$31.00+$3.51
  3. Washington, DC area · District of Columbia$31.62+$4.13
  4. Miami, FL · Florida$30.68+$3.19
  5. Chicago, IL · Illinois$30.20+$2.71
  6. Manhattan, NY · New York$32.10+$4.61
  7. Alaska · Alaska$37.63+$10.14

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

Every other payment area

G0296 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$27.00$21.44
ArkansasArkansas$26.78$21.33
ArizonaArizona$28.26$22.11
Bakersfield, CACalifornia$29.66$22.70
Chico, CACalifornia$29.55$22.59
El Centro, CACalifornia$29.55$22.60
Fresno, CACalifornia$29.55$22.59
Hanford, CACalifornia$29.55$22.59

G0296 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.

$26.78

$37.63

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

View every state and territory as a table
G0296 office rate range by state
State / territoryOffice rate rangeLocalities
AK$37.631
AL$27.001
AR$26.781
AZ$28.261
CA$29.55–$34.7529
CO$29.381
CT$30.081
DC$31.621
DE$28.591
FL$28.77–$30.683
GA$27.80–$29.142
GU$29.721
HI$29.721
IA$27.241
ID$27.371
IL$28.39–$30.204
IN$27.451
KS$27.231
KY$27.491
LA$27.49–$28.252
MA$29.35–$31.342
MD$28.94–$31.623
ME$27.52–$28.262
MI$27.95–$29.052
MN$28.321
MO$27.27–$28.233
MS$27.021
MT$28.721
NC$27.671
ND$28.131
NE$27.301
NH$29.021
NJ$30.47–$31.542
NM$28.071
NV$28.571
NY$27.91–$32.655
OH$27.831
OK$27.391
OR$28.39–$29.902
PA$27.82–$29.662
PR$28.821
RI$29.291
SC$27.791
SD$28.061
TN$27.321
TX$27.72–$29.258
UT$28.001
VA$28.25–$31.622
VI$28.821
VT$28.131
WA$29.26–$31.762
WI$27.601
WV$27.801
WY$28.461

See G0296 in every payment locality

How the G0296 rate is calculated

Each of G0296’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 · G0296

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.52

0.52 RVUs× 1.000 GPCI

Practice expense0.31

0.31 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

0.8600

Conversion factor

$33.4009

Medicare rate

$28.72

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

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,178

Code
G0296
Physician work
0.52
Practice expense
0.31
Malpractice
0.03

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for G0296 in Kentucky
ComponentRVULocality factorAdjusted
Physician work0.52× 1.0000.5200
Practice expense0.31× 0.8890.2756
Malpractice0.03× 0.9150.0274
Total RVUs0.8230
Conversion factor× 33.4009

Office rate, Kentucky$27.49

Office: (0.52 × 1 + 0.31 × 0.889 + 0.03 × 0.915) × $33.4009 = $27.49

Facility: (0.52 × 1 + 0.12 × 0.889 + 0.03 × 0.915) × $33.4009 = $21.85

Open G0296 in the RVU calculator

Payment rules and modifiers for G0296

G0296 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 · G0296

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$28.72

Non-facility (office)
$28.72
Facility
$22.38

Higher because the practice carries its own overhead.

How G0296 has changed in Kentucky

G0296 · Office / nonfacility

$27.49

Effective 2026-10-01

The base rate is $1.84 higher than on 2025-10-01, moving from $25.65 to $27.49 (7.2%).

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

    $25.65changed to$27.49

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.28 changed to 0.31
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $26.40changed to$25.65

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $25.96changed to$26.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $27.08changed to$25.96

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.04 changed to 0.03
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913
  5. January 1, 2023

    RVU23A

    $27.56changed to$27.08

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $27.49changed to$27.56

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.27 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $28.45changed to$27.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.26 changed to 0.27
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $27.87changed to$28.45

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.03 changed to 0.05
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $27.84changed to$27.87

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $27.39changed to$27.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.25 changed to 0.26
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $27.28changed to$27.39

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$27.28

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$27.49$21.85RVU26D
2026-07-01$27.49$21.85RVU26C
2026-04-01$27.49$21.85RVU26B
2026-01-01$27.49$21.85RVU26A
2025-10-01$25.65$23.38RVU25D
2025-07-01$25.65$23.38RVU25C
2025-04-01$25.65$23.38RVU25B
2025-01-01$25.65$23.38RVU25A
2024-10-01$26.40$24.06RVU24D
2024-07-01$26.40$24.06RVU24C
2024-04-01$26.40$24.06RVU24B
2024-03-09$26.40$24.06RVU24AR
2024-01-01$25.96$23.67RVU24A
2023-10-01$27.08$24.72RVU23D
2023-07-01$27.08$24.72RVU23C
2023-04-01$27.08$24.72RVU23B
2023-01-01$27.08$24.72RVU23A
2022-10-01$27.56$25.15RVU22D
2022-07-01$27.56$25.15RVU22C
2022-04-01$27.56$25.15RVU22B
2022-01-01$27.56$25.15RVU22A
2021-10-01$27.49$25.36RVU21D
2021-07-01$27.49$25.36RVU21C
2021-04-01$27.49$25.36RVU21B
2021-01-01$27.49$25.36RVU21A
2020-10-01$28.45$26.56RVU20D
2020-07-01$28.45$26.56RVU20C
2020-04-01$28.45$26.56RVU20B
2020-01-01$28.45$26.56RVU20A
2019-10-01$27.87$25.97RVU19D
2019-07-01$27.87$25.97RVU19C
2019-04-01$27.87$25.97RVU19B
2019-01-01$27.87$25.97RVU19A
2018-10-01$27.84$25.94RVU18D
2018-07-01$27.84$25.94RVU18C
2018-04-01$27.84$25.94RVU18B
2018-01-01$27.84$25.94RVU18AR1
2017-10-01$27.39$25.82RVU17D
2017-07-01$27.39$25.82RVU17C
2017-04-01$27.39$25.82RVU17B
2017-01-01$27.39$25.82RVU17A
2016-10-01$27.28$25.72RVU16D
2016-07-01$27.28$25.72RVU16C
2016-04-01$27.28$25.72RVU16B
2016-01-01$27.28$25.72RVU16A
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 G0296 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

G0296 billing questions

Does G0296 include the low-dose CT scan?

No. G0296 describes the eligibility and shared decision-making visit. The screening CT is reported separately with 71271.

Which patients meet the Medicare screening criteria?

The patient must be asymptomatic, age 50 through 77, have at least a 20 pack-year smoking history, and currently smoke or have quit within the past 15 years.

What documentation supports G0296?

Record the patient’s age, smoking and quit history, lack of symptoms, eligibility assessment, decision-aid use, and discussion of screening benefits, harms, adherence, comorbidities, and willingness to pursue treatment.

Is G0296 reported for every annual screening CT?

G0296 describes the initial eligibility and shared decision-making visit before the first screening LDCT. It is not the code for subsequent annual scans.

Can smoking cessation counseling codes replace G0296?

No. Codes 99406 and 99407 describe smoking and tobacco-use cessation counseling; they do not represent the full LDCT eligibility assessment and shared decision-making 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 G0296PPRRVU2026_Oct_nonQPP.csv, line 15,178 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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