HCPCS code G0318: Prolonged home visit, each additional 15 minutes2026 Medicare rate & RVUs in Illinois
Reports each additional 15 minutes of prolonged physician or qualified professional time for eligible high-level home or residence evaluation and management services.
Medicare pays $33.96–$36.43 for G0318 in the office in Illinois, from Rest of Illinois to Chicago, IL. Which amount applies depends on the service address.
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 G0318 covers
G0318 accounts for additional physician or qualified health care professional time spent on a prolonged evaluation and management service in a patient's home or residence. It is used with eligible high-level home or residence visits, such as a complex assessment in a private home or assisted living residence. The additional time may include work performed on the date of the visit with or without the patient present, consistent with the applicable E/M time rules.
Report G0318 only with an eligible primary home or residence E/M service, such as 99345 or 99350; it is not a standalone visit code. Select the primary service based on the applicable E/M criteria, and document total time and the work supporting the prolonged service. Each unit represents an additional 15 minutes. CMS classifies G0318 as an add-on code paid within the primary procedure's global period, so report it with that primary service rather than as a separate encounter.
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 G0318 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$33.96 to $36.43
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $36.43 | $29.72 |
| East St. Louis, IL | $34.80 | $28.65 |
| Rest of Illinois | $33.96 | $27.86 |
| Suburban Chicago, IL | $35.83 | $28.96 |
How the G0318 rate is calculated
Each of G0318’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 · G0318
RVUs × geographic indexes × conversion factor
Work0.61
0.61 RVUs× 1.000 GPCI
Practice expense0.36
0.36 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.0200
Conversion factor
$33.4009
Medicare rate
$34.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0318
The CMS indicators that decide how G0318 is paid alongside other services.
CMS payment indicators · G0318
Prolonged home visit, each additional 15 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
G0318 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0317Prolonged E/MNursing facility, each 15 minutes
- Use G0318 for prolonged home or residence E/M time; G0317 is the prolonged-service code for nursing facility E/M.
- G0316Prolonged E/MInpatient or observation care
- G0318 applies to home or residence visits, while G0316 applies to prolonged inpatient or observation E/M services.
- G2212Prolonged office visitMedicare add-on, each 15 minutes
- G0318 is for eligible home or residence E/M services. G2212 is used for qualifying prolonged office or outpatient E/M services.
G0318 billing questions
Which primary E/M codes can be paired with G0318?
G0318 is used with eligible high-level home or residence E/M services, including 99345 for a new patient and 99350 for an established patient.
Can G0318 be billed by itself?
No. CMS identifies it as an add-on code, so it must be reported with a qualifying primary home or residence E/M service.
How much time does one unit represent?
Each unit represents an additional 15 minutes of prolonged service time. Document the time and the work supporting the primary and prolonged services.
Can G0318 be used for a prolonged office visit?
No. G0318 is for prolonged home or residence E/M services. Prolonged office or outpatient E/M services use a different code pathway.
How does the global-period rule affect reporting?
CMS places payment for this add-on within the primary procedure's global period. Report G0318 with the primary home or residence E/M service, not as a separate encounter.
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.
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