$75.98–$107.55
Use G0081 for the established-patient 20-minute level and G0082 for the 30-minute level.
On this page
CMS RVU26D · Effective 2026-10-01
G0081 Home care visit Medicare reimbursement rates
Reports a 20-minute home-based care management visit for an established patient, with the service level supported by the encounter documentation. Compare G0081 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for G0081?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$46.71–$66.49
109 of 109 localities have a supported rate.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where G0081 pays more and less
109 payment localities
$46.71 to $66.49
Care management
About G0081: Established patient home care management visit
Reports a 20-minute home-based care management visit for an established patient, with the service level supported by the encounter documentation.
G0081 describes a care management visit in the established patient's home at the 20-minute level. The clinician addresses the patient's ongoing care needs during an in-home encounter, such as reviewing the current management approach and coordinating care. The code is distinct from a home care-plan service and from a routine office visit; the record should make clear that the encounter occurred in the home and involved care management.
Select G0081 when the patient is established and the documented service supports this 20-minute level. Record the patient's established status, home setting, work performed, and time attributable to the service. CMS assigns the code work, practice-expense, and malpractice relative value units under the physician fee schedule. The submitted record should support the selected time level; the descriptor alone does not establish additional units.
Where the value comes from
- Work RVU1.00 · 68%
- Practice expense (office) RVU0.44 · 30%
- Malpractice RVU0.04 · 3%
57
Medicare services in 2024 · #5277 by national volume
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.
G0081 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$46.76–$66.63
The time level is 20 minutes for both codes; G0076 is for a new patient, while G0081 is for an established patient.
$68.15–$95.06
G0086 identifies a home care-plan service at the 30-minute level. G0081 identifies an established-patient care management home visit at the 20-minute level.
See how rates vary across the country
G0081 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$46.71
$66.49
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $66.49 | 1 |
| AL | $47.02 | 1 |
| AR | $46.71 | 1 |
| AZ | $48.79 | 1 |
| CA | $50.79–$58.98 | 29 |
| CO | $50.48 | 1 |
| CT | $51.51 | 1 |
| DC | $54.00 | 1 |
| DE | $49.29 | 1 |
| FL | $49.46–$52.08 | 3 |
| GA | $48.10–$50.04 | 2 |
| GU | $50.88 | 1 |
| HI | $50.88 | 1 |
| IA | $47.38 | 1 |
| ID | $47.55 | 1 |
| IL | $48.91–$51.47 | 4 |
| IN | $47.67 | 1 |
| KS | $47.36 | 1 |
| KY | $47.69 | 1 |
| LA | $47.69–$48.75 | 2 |
| MA | $50.48–$53.51 | 2 |
| MD | $49.83–$54.00 | 3 |
| ME | $47.75–$48.81 | 2 |
| MI | $48.33–$49.84 | 2 |
| MN | $48.92 | 1 |
| MO | $47.37–$48.73 | 3 |
| MS | $47.04 | 1 |
| MT | $49.43 | 1 |
| NC | $47.97 | 1 |
| ND | $48.64 | 1 |
| NE | $47.47 | 1 |
| NH | $49.87 | 1 |
| NJ | $52.25–$53.98 | 2 |
| NM | $48.48 | 1 |
| NV | $49.22 | 1 |
| NY | $48.30–$55.49 | 5 |
| OH | $48.17 | 1 |
| OK | $47.56 | 1 |
| OR | $48.98–$51.26 | 2 |
| PA | $48.15–$50.89 | 2 |
| PR | $49.57 | 1 |
| RI | $50.41 | 1 |
| SC | $48.12 | 1 |
| SD | $48.55 | 1 |
| TN | $47.48 | 1 |
| TX | $48.02–$50.20 | 8 |
| UT | $48.42 | 1 |
| VA | $48.79–$54.00 | 2 |
| VI | $49.57 | 1 |
| VT | $48.63 | 1 |
| WA | $50.33–$54.19 | 2 |
| WI | $47.89 | 1 |
| WV | $48.08 | 1 |
| WY | $49.09 | 1 |
Compare G0081 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $47.02 | Facility Unavailable |
| Alaska* | Office $66.49 | Facility Unavailable |
| Arizona | Office $48.79 | Facility Unavailable |
| Arkansas | Office $46.71 | Facility Unavailable |
| Atlanta | Office $50.04 | Facility Unavailable |
| Austin | Office $50.20 | Facility Unavailable |
| Bakersfield | Office $50.96 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $51.36 | Facility Unavailable |
| Beaumont | Office $48.02 | Facility Unavailable |
| Brazoria | Office $49.27 | Facility Unavailable |
| Chicago | Office $51.47 | Facility Unavailable |
| Chico | Office $50.79 | Facility Unavailable |
| Colorado | Office $50.48 | Facility Unavailable |
| Connecticut | Office $51.51 | Facility Unavailable |
| Dallas | Office $49.49 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $54.00 | Facility Unavailable |
| Delaware | Office $49.29 | Facility Unavailable |
| Detroit | Office $49.84 | Facility Unavailable |
| East St. Louis | Office $49.61 | Facility Unavailable |
| El Centro | Office $50.80 | Facility Unavailable |
| Fort Lauderdale | Office $50.70 | Facility Unavailable |
| Fort Worth | Office $49.36 | Facility Unavailable |
| Fresno | Office $50.79 | Facility Unavailable |
| Galveston | Office $49.37 | Facility Unavailable |
| Hanford-Corcoran | Office $50.79 | Facility Unavailable |
| Hawaii, Guam | Office $50.88 | Facility Unavailable |
| Houston | Office $50.10 | Facility Unavailable |
| Idaho | Office $47.55 | Facility Unavailable |
| Indiana | Office $47.67 | Facility Unavailable |
| Iowa | Office $47.38 | Facility Unavailable |
| Kansas | Office $47.36 | Facility Unavailable |
| Kentucky | Office $47.69 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $53.04 | Facility Unavailable |
| Madera | Office $50.79 | Facility Unavailable |
| Manhattan | Office $54.73 | Facility Unavailable |
| Merced | Office $50.79 | Facility Unavailable |
| Metropolitan Boston | Office $53.51 | Facility Unavailable |
| Metropolitan Kansas City | Office $48.51 | Facility Unavailable |
| Metropolitan Philadelphia | Office $50.89 | Facility Unavailable |
| Metropolitan St. Louis | Office $48.73 | Facility Unavailable |
| Miami | Office $52.08 | Facility Unavailable |
| Minnesota | Office $48.92 | Facility Unavailable |
| Mississippi | Office $47.04 | Facility Unavailable |
| Modesto | Office $50.79 | Facility Unavailable |
| Montana** | Office $49.43 | Facility Unavailable |
| Napa | Office $55.55 | Facility Unavailable |
| Nebraska | Office $47.47 | Facility Unavailable |
| Nevada** | Office $49.22 | Facility Unavailable |
| New Hampshire | Office $49.87 | Facility Unavailable |
| New Mexico | Office $48.48 | Facility Unavailable |
| New Orleans | Office $48.75 | Facility Unavailable |
| North Carolina | Office $47.97 | Facility Unavailable |
| North Dakota** | Office $48.64 | Facility Unavailable |
| Northern Nj | Office $53.98 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $55.49 | Facility Unavailable |
| Ohio | Office $48.17 | Facility Unavailable |
| Oklahoma | Office $47.56 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $52.54 | Facility Unavailable |
| Portland | Office $51.26 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $52.61 | Facility Unavailable |
| Puerto Rico | Office $49.57 | Facility Unavailable |
| Queens | Office $54.84 | Facility Unavailable |
| Redding | Office $50.79 | Facility Unavailable |
| Rest Of California | Office $50.79 | Facility Unavailable |
| Rest Of Florida | Office $49.46 | Facility Unavailable |
| Rest Of Georgia | Office $48.10 | Facility Unavailable |
| Rest Of Illinois | Office $48.91 | Facility Unavailable |
| Rest Of Louisiana | Office $47.69 | Facility Unavailable |
| Rest Of Maine | Office $47.75 | Facility Unavailable |
| Rest Of Maryland | Office $49.83 | Facility Unavailable |
| Rest Of Massachusetts | Office $50.48 | Facility Unavailable |
| Rest Of Michigan | Office $48.33 | Facility Unavailable |
| Rest Of Missouri | Office $47.37 | Facility Unavailable |
| Rest Of New Jersey | Office $52.25 | Facility Unavailable |
| Rest Of New York | Office $48.30 | Facility Unavailable |
| Rest Of Oregon | Office $48.98 | Facility Unavailable |
| Rest Of Pennsylvania | Office $48.15 | Facility Unavailable |
| Rest Of Texas | Office $48.55 | Facility Unavailable |
| Rest Of Washington | Office $50.33 | Facility Unavailable |
| Rhode Island | Office $50.41 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $51.25 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $52.41 | Facility Unavailable |
| Salinas | Office $52.19 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $52.70 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $57.91 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $57.86 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $58.98 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $58.80 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $51.42 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $52.67 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $52.19 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $53.17 | Facility Unavailable |
| Seattle (King Cnty) | Office $54.19 | Facility Unavailable |
| South Carolina | Office $48.12 | Facility Unavailable |
| South Dakota** | Office $48.55 | Facility Unavailable |
| Southern Maine | Office $48.81 | Facility Unavailable |
| Stockton | Office $50.79 | Facility Unavailable |
| Suburban Chicago | Office $51.10 | Facility Unavailable |
| Tennessee | Office $47.48 | Facility Unavailable |
| Utah | Office $48.42 | Facility Unavailable |
| Vallejo | Office $55.49 | Facility Unavailable |
| Vermont | Office $48.63 | Facility Unavailable |
| Virgin Islands | Office $49.57 | Facility Unavailable |
| Virginia | Office $48.79 | Facility Unavailable |
| Visalia | Office $50.79 | Facility Unavailable |
| West Virginia | Office $48.08 | Facility Unavailable |
| Wisconsin | Office $47.89 | Facility Unavailable |
| Wyoming** | Office $49.09 | Facility Unavailable |
| Yuba City | Office $50.79 | Facility Unavailable |
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G0081 billing questions
How does G0081 differ from G0082?
Both describe care management home visits for established patients. G0081 is the 20-minute level; G0082 is the 30-minute level.
Can G0081 be used for a new patient?
No. G0081 is for an established patient. The corresponding 20-minute new-patient home visit code is G0076.
What time should the record support?
Document the time attributable to the care management service and the work performed during the home visit. The code identifies the 20-minute level.
How is G0081 different from G0086?
G0081 identifies a care management home visit for an established patient. G0086 describes a home care-plan service, so choose based on the service documented rather than treating the codes as interchangeable.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
15,070G0078,,Care manag h vst new pt 45 m,A,,2.53,0.95,,0.95,NA,0.12,3.60,3.60,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,071G0079,,Care manag h vst new pt 60 m,A,,3.38,1.36,,1.36,NA,0.16,4.90,4.90,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,072G0080,,Care manag h vst new pt 75 m,A,,4.09,2.16,,2.16,NA,0.25,6.50,6.50,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,073G0081,,Care man h v ext pt 20 mi,A,,1.00,0.44,,0.44,NA,0.04,1.48,1.48,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,074G0082,,Care man h v ext pt 30 m,A,,1.56,0.79,,0.79,NA,0.07,2.42,2.42,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,075G0083,,Care man h v ext pt 45 m,A,,2.33,1.36,,1.36,NA,0.16,3.85,3.85,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,076G0084,,Care man h v ext pt 60 m,A,,3.28,1.94,,1.94,NA,0.24,5.46,5.46,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00