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

In Virginia, Medicare pays $28.25 for G0296 in the office and $22.02 when it’s performed in a hospital or facility.

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.

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 Virginia 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. Virginia pays $28.25. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

G0296 rates by state

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

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.

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.

Codes related to G0296

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

How G0296 has changed in Virginia

Price G0296 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

• Abbs Valley
• Abingdon
• Accomac
• Adwolf
• Afton
• Alberta
• Aldie
• Allison Gap

Browse all communities in Virginia

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