HCPCS G0079: Care management visitMedicare rate & RVUs

Medicare pays $163.66 for G0079 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 G0079 covers

G0079 identifies a care-management home visit for a new patient, with a 60-minute service duration. It describes work delivered during a visit in the patient's residence, rather than a routine office encounter. The descriptor does not specify a diagnosis, particular disease, or required discipline; the record should explain what care-management work was performed and why the visit took place at home.

Select this code when the patient meets the applicable new-patient definition and the documented visit duration matches the 60-minute level, rather than an adjacent duration level. Document the home setting, new-patient status, duration, and the care-management activities performed. CMS assigns work, practice-expense, and malpractice relative value units to the service; those resource inputs inform physician fee schedule payment.

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 G0079 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

G0079 rates by state

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

How the G0079 rate is calculated

Each of G0079’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 G0079

G0079 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.

G0079 compared with similar codes

How to choose

G0078Home care management

Both are new-patient care-management home visits; G0078 is the 45-minute level, while G0079 is the 60-minute level.

G0080Home care management

Both describe new-patient care-management home visits; G0080 is the 75-minute level, while G0079 is the 60-minute level.

G0084Home care management

G0084 is the 60-minute care-management home visit for an established patient. G0079 is the corresponding new-patient level.

G0087Care management

G0087 describes a 60-minute home care-plan service. G0079 describes a 60-minute new-patient care-management home visit.

Codes related to G0079

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