HCPCS code G2004: Home visit, new patient, 60 minutes2026 Medicare rate & RVUs

Medicare pays $163.66 for G2004 nationally in the office. Local office rates run $154.67–$220.67.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What G2004 covers

G2004 describes a home visit after a beneficiary’s discharge, with the service documented at the 60-minute level for a new patient. A physician or other qualified health care professional assesses the beneficiary in the residence, such as during recovery after a hospital stay. The encounter may address current symptoms, medication use, mobility, support at home, and the need for further care.

Choose the new-patient series when the beneficiary meets the applicable new-patient definition; use the established-patient series otherwise. Document the discharge context, home setting, new-patient status, time supporting the selected level, clinical assessment, and plan. CMS assigns the code work, practice-expense, and malpractice relative value units under the Physician Fee Schedule. G2003 and G2005 are the neighboring new-patient levels for 45 and 75 minutes, respectively.

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 G2004 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

G2004 rates by state

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

How the G2004 rate is calculated

Each of G2004’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 G2004

G2004 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.

G2004 compared with similar codes

How to choose

G2003Home visitNew patient, 45 minutes

G2003 is the 45-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.

G2005Home visitNew patient, 75 minutes

G2005 is the 75-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.

G2009Home visitEstablished patient, 60 minutes

G2009 is for an established patient at the 60-minute level. G2004 is the corresponding new-patient level.

Codes related to G2004

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

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