HCPCS code G0402: Welcome visit, first 12 months of Part B2026 Medicare rate & RVUs in South Dakota

G0402 reports Medicare’s one-time Welcome to Medicare visit, including a prevention-focused health review and examination during the initial Part B enrollment period.

CMS RVU26DEffective Oct 1, 2026One payment locality538K Medicare services in 2024

In South Dakota, Medicare pays $170.92 for G0402 in the office and $110.46 when it’s performed in a hospital or facility.

$170.92Office (non-facility)
$110.46Hospital or facility
−2.2%vs the national office rate ($174.69)

Check a contract rate as a % of Medicare · G0402 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 G0402 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What G0402 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 G0402 covers

G0402 covers the one-time Welcome to Medicare visit, a prevention-focused review rather than a routine comprehensive physical. A physician or qualified nonphysician practitioner typically performs it in an office or outpatient setting. The clinician reviews medical and social history, assesses health risks, depression risk, functional ability and safety, performs an appropriate examination, and provides prevention counseling and a written screening schedule. Advance care planning may be discussed when the patient chooses to address it.

Report G0402 when the patient is within the first 12 months of Part B enrollment and the visit’s documented elements support the service. Record relevant history, risk and functional assessments, examination findings, counseling, and recommended preventive services. If a screening ECG is furnished, report the applicable ECG service separately using G0403 or its tracing and interpretation components, G0404 and G0405.

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 South Dakota compares for G0402

Across 109 of 109 payment localities, the office rate for G0402 runs from $160.35 in Arkansas to $220.90 in Alaska. South Dakota pays $170.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0402 in South Dakota vs other payment areas
  1. South Dakota · this page$170.92
  2. Los Angeles, CA · California$191.38+$20.46
  3. Washington, DC area · District of Columbia$194.64+$23.72
  4. Miami, FL · Florida$186.74+$15.82
  5. Chicago, IL · Illinois$183.06+$12.14
  6. Manhattan, NY · New York$196.88+$25.96
  7. Alaska · Alaska$220.90+$49.98

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

Every other payment area

G0402 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$161.95$109.05
ArkansasArkansas$160.35$108.42
ArizonaArizona$171.32$112.74
Bakersfield, CACalifornia$182.00$115.75
Chico, CACalifornia$181.42$115.16
El Centro, CACalifornia$181.44$115.19
Fresno, CACalifornia$181.42$115.16
Hanford, CACalifornia$181.42$115.16

G0402 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.

$160.35

$220.90

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

View every state and territory as a table
G0402 office rate range by state
State / territoryOffice rate rangeLocalities
AK$220.901
AL$161.951
AR$160.351
AZ$171.321
CA$181.42–$217.9229
CO$179.741
CT$183.941
DC$194.641
DE$173.561
FL$173.93–$186.743
GA$166.90–$177.402
GU$183.551
HI$183.551
IA$164.281
ID$165.121
IL$170.74–$183.064
IN$165.771
KS$163.981
KY$165.081
LA$165.00–$170.612
MA$179.28–$193.562
MD$176.08–$194.643
ME$165.97–$171.852
MI$168.27–$175.712
MN$173.071
MO$163.20–$170.753
MS$161.781
MT$174.681
NC$167.131
ND$171.311
NE$164.831
NH$177.351
NJ$186.27–$193.692
NM$169.011
NV$173.821
NY$168.89–$200.645
OH$167.581
OK$164.631
OR$172.67–$183.742
PA$167.64–$180.712
PR$175.511
RI$178.431
SC$167.591
SD$170.921
TN$164.581
TX$166.89–$178.988
UT$169.181
VA$171.62–$194.642
VI$175.511
VT$171.061
WA$178.81–$196.642
WI$167.311
WV$166.371
WY$173.211

See G0402 in every payment locality

How the G0402 rate is calculated

Each of G0402’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 · G0402

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.60

2.60 RVUs× 1.000 GPCI

Practice expense2.46

2.46 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

5.2300

Conversion factor

$33.4009

Medicare rate

$174.69

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

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,231

Code
G0402
Physician work
2.60
Practice expense
2.46
Malpractice
0.17

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for G0402 in South Dakota
ComponentRVULocality factorAdjusted
Physician work2.60× 1.0002.6000
Practice expense2.46× 1.0002.4600
Malpractice0.17× 0.3360.0571
Total RVUs5.1171
Conversion factor× 33.4009

Office rate, South Dakota$170.92

Office: (2.6 × 1 + 2.46 × 1 + 0.17 × 0.336) × $33.4009 = $170.92

Facility: (2.6 × 1 + 0.65 × 1 + 0.17 × 0.336) × $33.4009 = $110.46

Open G0402 in the RVU calculator

Payment rules and modifiers for G0402

G0402 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 · G0402

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$174.69

Non-facility (office)
$174.69
Facility
$114.23

Higher because the practice carries its own overhead.

How G0402 has changed in South Dakota

G0402 · Office / nonfacility

$170.92

Effective 2026-10-01

The base rate is $13.36 higher than on 2025-10-01, moving from $157.56 to $170.92 (8.5%).

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

    $157.56changed to$170.92

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.21 changed to 2.46
    • Malpractice RVU 0.16 changed to 0.17
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $162.27changed to$157.56

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $159.63changed to$162.27

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $162.85changed to$159.63

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.14 changed to 2.21
    • Malpractice RVU 0.18 changed to 0.17
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $165.73changed to$162.85

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.13 changed to 2.14
    • Malpractice RVU 0.17 changed to 0.18
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $166.16changed to$165.73

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.11 changed to 2.13
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $165.57changed to$166.16

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 2.43 changed to 2.60
    • Malpractice RVU 0.13 changed to 0.15
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $165.72changed to$165.57

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.15 changed to 0.13
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $166.62changed to$165.72

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.14 changed to 2.11

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $165.42changed to$166.62

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.12 changed to 2.14
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $164.34changed to$165.42

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.10 changed to 2.12
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $165.44changed to$164.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.11 changed to 2.10
    • Malpractice RVU 0.16 changed to 0.15

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $164.61changed to$165.44

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $162.48changed to$164.61

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.06 changed to 2.11
    • Malpractice RVU 0.11 changed to 0.16
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $161.33changed to$162.48

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.26 changed to 2.06
    • Malpractice RVU 0.12 changed to 0.11
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $161.33

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$170.92$110.46RVU26D
2026-07-01$170.92$110.46RVU26C
2026-04-01$170.92$110.46RVU26B
2026-01-01$170.92$110.46RVU26A
2025-10-01$157.56$122.63RVU25D
2025-07-01$157.56$122.63RVU25C
2025-04-01$157.56$122.63RVU25B
2025-01-01$157.56$122.63RVU25A
2024-10-01$162.27$126.32RVU24D
2024-07-01$162.27$126.32RVU24C
2024-04-01$162.27$126.32RVU24B
2024-03-09$162.27$126.32RVU24AR
2024-01-01$159.63$124.26RVU24A
2023-10-01$162.85$127.60RVU23D
2023-07-01$162.85$127.60RVU23C
2023-04-01$162.85$127.60RVU23B
2023-01-01$162.85$127.60RVU23A
2022-10-01$165.73$131.12RVU22D
2022-07-01$165.73$131.12RVU22C
2022-04-01$165.73$131.12RVU22B
2022-01-01$165.73$131.12RVU22A
2021-10-01$166.16$132.32RVU21D
2021-07-01$166.16$132.32RVU21C
2021-04-01$166.16$132.32RVU21B
2021-01-01$166.16$132.32RVU21A
2020-10-01$165.57$126.24RVU20D
2020-07-01$165.57$126.24RVU20C
2020-04-01$165.57$126.24RVU20B
2020-01-01$165.57$126.24RVU20A
2019-10-01$165.72$125.72RVU19D
2019-07-01$165.72$125.72RVU19C
2019-04-01$165.72$125.72RVU19B
2019-01-01$165.72$125.72RVU19A
2018-10-01$166.62$126.30RVU18D
2018-07-01$166.62$126.30RVU18C
2018-04-01$166.62$126.30RVU18B
2018-01-01$166.62$126.30RVU18AR1
2017-10-01$165.42$125.94RVU17D
2017-07-01$165.42$125.94RVU17C
2017-04-01$165.42$125.94RVU17B
2017-01-01$165.42$125.94RVU17A
2016-10-01$164.34$124.96RVU16D
2016-07-01$164.34$124.96RVU16C
2016-04-01$164.34$124.96RVU16B
2016-01-01$164.34$124.96RVU16A
2015-10-01$165.44$125.91RVU15D
2015-07-01$165.44$125.91RVU15C
2015-04-01$164.61$125.28RVU15B
2015-01-01$164.61$125.28RVU15A
2014-10-01$162.48$124.15RVU14D
2014-07-01$162.48$124.15RVU14C
2014-04-01$162.48$124.15RVU14B
2014-01-01$162.48$124.15RVU14A
2013-10-01$161.33$120.50RVU13D
2013-07-01$161.33$120.50RVU13C
2013-04-01$161.33$120.50RVU13B
2013-01-01$161.33$120.50RVU13AR

Price G0402 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

G0402 billing questions

How is G0402 different from the initial Annual Wellness Visit?

G0402 is the one-time Welcome to Medicare visit available during the first 12 months of Part B enrollment. G0438 reports the initial Annual Wellness Visit, a separate preventive benefit.

Can G0402 be reported again as an annual visit?

No. G0402 is a one-time benefit, not a recurring annual visit code. Use the applicable Annual Wellness Visit code for a qualifying later wellness visit.

How should an ECG furnished at the visit be reported?

Report the ECG using G0403 when the service includes the tracing, interpretation, and report. G0404 and G0405 identify the tracing and interpretation/report portions, respectively.

What documentation supports G0402?

Document the patient’s Part B enrollment timing and the visit elements performed, including history, health-risk and functional assessments, examination, counseling, and preventive-service recommendations.

Is G0402 selected by visit time?

No time threshold is used to distinguish G0402. Selection is based on the patient’s eligibility for the one-time benefit and the documented preventive-visit elements.

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 G0402PPRRVU2026_Oct_nonQPP.csv, line 15,231 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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