HCPCS G0078: Home care managementMedicare rate & RVUs

Medicare pays $120.24 for G0078 nationally in the office. Local office rates run $113.83–$162.76.

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

What G0078 covers

G0078 represents a care-management home visit for a new patient, with 45 minutes as its time designation. The service takes place in the patient’s home and focuses on care-management work during the visit. It is distinct from an office encounter and from other home-visit levels that specify a different patient category or duration.

Report G0078 when the record supports the new-patient category, home setting, care-management service, and 45-minute level. Documentation should identify the care needs addressed, the work performed during the visit, and the time supporting the selected level. CMS assigns relative value units for physician work, practice expense, and malpractice; the practice-expense valuation includes office and facility settings.

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 G0078 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

G0078 rates by state

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

How the G0078 rate is calculated

Each of G0078’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 G0078

G0078 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.

G0078 compared with similar codes

How to choose

G0077Home care management

G0077 identifies a new-patient care-management home visit at the 30-minute level; G0078 identifies the 45-minute level.

G0079Care management visit

Both are new-patient care-management home-visit levels. G0079 specifies 60 minutes rather than 45 minutes.

G0083Care management visit

G0083 is the 45-minute level for an established patient. G0078 is for a new patient.

G0086Care management

G0086 describes a care-management home-care-plan service with a 30-minute designation, rather than G0078’s new-patient home-visit level.

Codes related to G0078

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