HCPCS G0238: Respiratory therapyMedicare rate & RVUs

Medicare pays $11.36 for G0238 nationally in the office. Local office rates run $9.64–$16.07.

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

What G0238 covers

G0238 represents individualized respiratory therapy intended to improve respiratory function through therapeutic procedures outside the respiratory-muscle strength or endurance work assigned to G0237. A respiratory therapist or other clinical staff member typically provides the face-to-face treatment in an outpatient respiratory-care or pulmonary rehabilitation setting. The service is delivered to one patient at a time, and monitoring is included.

Report the service in 15-minute units, supported by documentation of the procedures performed and the face-to-face treatment time. The record should distinguish the work from respiratory-muscle strength or endurance training and from a group session. CMS treats G0238 as an incident-to service: it may be billed only when performed under physician supervision. Its fee schedule relative-value profile assigns no physician work RVUs; practice expense and malpractice RVUs are included.

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 G0238 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

G0238 rates by state

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

How the G0238 rate is calculated

Each of G0238’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 G0238

The CMS indicators that decide how G0238 is paid alongside other services.

G0238 compared with similar codes

How to choose

G0237Respiratory therapy

Choose G0237 when the individual treatment targets respiratory-muscle strength or endurance. G0238 covers other individualized procedures intended to improve respiratory function.

G0239Respiratory therapy

G0238 is an individual service; G0239 describes respiratory procedures delivered in a group setting.

Codes related to G0238

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