$160.06–$220.54
G0402 is the one-time Welcome to Medicare visit during the first 12 months of Part B enrollment. G0438 is the initial Annual Wellness Visit, a separate benefit.
On this page
CMS RVU26D · Effective 2026-10-01
G0402 Welcome visit Medicare reimbursement rates
G0402 reports Medicare’s one-time Welcome to Medicare visit, including a prevention-focused health review and examination during the initial Part B enrollment period. Compare G0402 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 G0402?
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
$160.35–$220.90
109 of 109 localities have a 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 G0402 pays more and less
109 payment localities
$160.35 to $220.90
Preventive medicine
About G0402: Initial Medicare preventive physical examination
G0402 reports Medicare’s one-time Welcome to Medicare visit, including a prevention-focused health review and examination during the initial Part B enrollment period.
G0402 covers the one-time Welcome to Medicare visit, a prevention-focused review rather than a routine comprehensive physical. A physician or qualified nonphysician practitioner typically performs it in an office or outpatient setting. The clinician reviews medical and social history, assesses health risks, depression risk, functional ability and safety, performs an appropriate examination, and provides prevention counseling and a written screening schedule. Advance care planning may be discussed when the patient chooses to address it.
Report G0402 when the patient is within the first 12 months of Part B enrollment and the visit’s documented elements support the service. Record relevant history, risk and functional assessments, examination findings, counseling, and recommended preventive services. If a screening ECG is furnished, report the applicable ECG service separately using G0403 or its tracing and interpretation components, G0404 and G0405. The CMS facts provided list no special payment rules for G0402.
Where the value comes from
- Work RVU2.60 · 50%
- Practice expense (office) RVU2.46 · 47%
- Malpractice RVU0.17 · 3%
538K
Medicare services in 2024 · #217 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.
G0402 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$125.76–$173.21
G0439 reports a subsequent Annual Wellness Visit. It is not used for the initial Welcome to Medicare service reported with G0402.
$13.77–$19.67
G0402 reports the preventive visit. G0403 reports the associated screening ECG service, including its tracing, interpretation, and report.
See how rates vary across the country
G0402 · 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.
$160.35
$220.90
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 | $220.90 | 1 |
| AL | $161.95 | 1 |
| AR | $160.35 | 1 |
| AZ | $171.32 | 1 |
| CA | $181.42–$217.92 | 29 |
| CO | $179.74 | 1 |
| CT | $183.94 | 1 |
| DC | $194.64 | 1 |
| DE | $173.56 | 1 |
| FL | $173.93–$186.74 | 3 |
| GA | $166.90–$177.40 | 2 |
| GU | $183.55 | 1 |
| HI | $183.55 | 1 |
| IA | $164.28 | 1 |
| ID | $165.12 | 1 |
| IL | $170.74–$183.06 | 4 |
| IN | $165.77 | 1 |
| KS | $163.98 | 1 |
| KY | $165.08 | 1 |
| LA | $165.00–$170.61 | 2 |
| MA | $179.28–$193.56 | 2 |
| MD | $176.08–$194.64 | 3 |
| ME | $165.97–$171.85 | 2 |
| MI | $168.27–$175.71 | 2 |
| MN | $173.07 | 1 |
| MO | $163.20–$170.75 | 3 |
| MS | $161.78 | 1 |
| MT | $174.68 | 1 |
| NC | $167.13 | 1 |
| ND | $171.31 | 1 |
| NE | $164.83 | 1 |
| NH | $177.35 | 1 |
| NJ | $186.27–$193.69 | 2 |
| NM | $169.01 | 1 |
| NV | $173.82 | 1 |
| NY | $168.89–$200.64 | 5 |
| OH | $167.58 | 1 |
| OK | $164.63 | 1 |
| OR | $172.67–$183.74 | 2 |
| PA | $167.64–$180.71 | 2 |
| PR | $175.51 | 1 |
| RI | $178.43 | 1 |
| SC | $167.59 | 1 |
| SD | $170.92 | 1 |
| TN | $164.58 | 1 |
| TX | $166.89–$178.98 | 8 |
| UT | $169.18 | 1 |
| VA | $171.62–$194.64 | 2 |
| VI | $175.51 | 1 |
| VT | $171.06 | 1 |
| WA | $178.81–$196.64 | 2 |
| WI | $167.31 | 1 |
| WV | $166.37 | 1 |
| WY | $173.21 | 1 |
Compare G0402 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 $161.95 | Facility $109.05 |
| Alaska* | Office $220.90 | Facility $156.51 |
| Arizona | Office $171.32 | Facility $112.74 |
| Arkansas | Office $160.35 | Facility $108.42 |
| Atlanta | Office $177.40 | Facility $115.98 |
| Austin | Office $178.98 | Facility $115.02 |
| Bakersfield | Office $182.00 | Facility $115.75 |
| Baltimore/Surr. Cntys | Office $183.42 | Facility $118.55 |
| Beaumont | Office $166.89 | Facility $111.87 |
| Brazoria | Office $173.39 | Facility $113.48 |
| Chicago | Office $183.06 | Facility $122.30 |
| Chico | Office $181.42 | Facility $115.16 |
| Colorado | Office $179.74 | Facility $115.42 |
| Connecticut | Office $183.94 | Facility $118.83 |
| Dallas | Office $174.33 | Facility $114.12 |
| Dc + Md/Va Suburbs | Office $194.64 | Facility $123.43 |
| Delaware | Office $173.56 | Facility $113.83 |
| Detroit | Office $175.71 | Facility $117.37 |
| East St. Louis | Office $173.87 | Facility $118.25 |
| El Centro | Office $181.44 | Facility $115.19 |
| Fort Lauderdale | Office $180.34 | Facility $119.10 |
| Fort Worth | Office $173.59 | Facility $113.98 |
| Fresno | Office $181.42 | Facility $115.16 |
| Galveston | Office $173.83 | Facility $113.80 |
| Hanford-Corcoran | Office $181.42 | Facility $115.16 |
| Hawaii, Guam | Office $183.55 | Facility $114.81 |
| Houston | Office $176.94 | Facility $116.91 |
| Idaho | Office $165.12 | Facility $109.50 |
| Indiana | Office $165.77 | Facility $109.73 |
| Iowa | Office $164.28 | Facility $108.96 |
| Kansas | Office $163.98 | Facility $109.33 |
| Kentucky | Office $165.08 | Facility $111.34 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $191.38 | Facility $119.86 |
| Madera | Office $181.42 | Facility $115.16 |
| Manhattan | Office $196.88 | Facility $126.63 |
| Merced | Office $181.42 | Facility $115.16 |
| Metropolitan Boston | Office $193.56 | Facility $121.38 |
| Metropolitan Kansas City | Office $169.54 | Facility $112.78 |
| Metropolitan Philadelphia | Office $180.71 | Facility $117.78 |
| Metropolitan St. Louis | Office $170.75 | Facility $113.20 |
| Miami | Office $186.74 | Facility $123.80 |
| Minnesota | Office $173.07 | Facility $110.86 |
| Mississippi | Office $161.78 | Facility $109.73 |
| Modesto | Office $181.42 | Facility $115.16 |
| Montana** | Office $174.68 | Facility $114.22 |
| Napa | Office $203.49 | Facility $123.81 |
| Nebraska | Office $164.83 | Facility $109.03 |
| Nevada** | Office $173.82 | Facility $113.30 |
| New Hampshire | Office $177.35 | Facility $114.41 |
| New Mexico | Office $169.01 | Facility $113.57 |
| New Orleans | Office $170.61 | Facility $113.72 |
| North Carolina | Office $167.13 | Facility $110.73 |
| North Dakota** | Office $171.31 | Facility $110.86 |
| Northern Nj | Office $193.69 | Facility $123.56 |
| Nyc Suburbs/Long Island | Office $200.64 | Facility $128.76 |
| Ohio | Office $167.58 | Facility $112.39 |
| Oklahoma | Office $164.63 | Facility $110.64 |
| Oxnard-Thousand Oaks-Ventura | Office $189.93 | Facility $118.47 |
| Portland | Office $183.74 | Facility $116.58 |
| Poughkpsie/N Nyc Suburbs | Office $187.59 | Facility $121.39 |
| Puerto Rico | Office $175.51 | Facility $114.38 |
| Queens | Office $197.71 | Facility $126.25 |
| Redding | Office $181.42 | Facility $115.16 |
| Rest Of California | Office $181.42 | Facility $115.16 |
| Rest Of Florida | Office $173.93 | Facility $116.13 |
| Rest Of Georgia | Office $166.90 | Facility $112.98 |
| Rest Of Illinois | Office $170.74 | Facility $115.54 |
| Rest Of Louisiana | Office $165.00 | Facility $111.50 |
| Rest Of Maine | Office $165.97 | Facility $110.35 |
| Rest Of Maryland | Office $176.08 | Facility $114.89 |
| Rest Of Massachusetts | Office $179.28 | Facility $115.62 |
| Rest Of Michigan | Office $168.27 | Facility $113.07 |
| Rest Of Missouri | Office $163.20 | Facility $111.09 |
| Rest Of New Jersey | Office $186.27 | Facility $120.25 |
| Rest Of New York | Office $168.89 | Facility $111.46 |
| Rest Of Oregon | Office $172.67 | Facility $112.46 |
| Rest Of Pennsylvania | Office $167.64 | Facility $112.14 |
| Rest Of Texas | Office $169.95 | Facility $112.57 |
| Rest Of Washington | Office $178.81 | Facility $115.15 |
| Rhode Island | Office $178.43 | Facility $115.98 |
| Riverside-San Bernardino-Ontario | Office $183.30 | Facility $117.04 |
| Sacramento-Roseville-Folsom | Office $188.57 | Facility $118.26 |
| Salinas | Office $187.81 | Facility $117.74 |
| San Diego-Chula Vista-Carlsbad | Office $190.80 | Facility $118.49 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $213.55 | Facility $128.31 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $213.36 | Facility $128.12 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $217.92 | Facility $130.75 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $217.13 | Facility $129.96 |
| San Luis Obispo-Paso Robles | Office $184.95 | Facility $116.09 |
| Santa Cruz-Watsonville | Office $191.54 | Facility $118.09 |
| Santa Maria-Santa Barbara | Office $188.12 | Facility $117.63 |
| Santa Rosa-Petaluma | Office $193.39 | Facility $119.15 |
| Seattle (King Cnty) | Office $196.64 | Facility $122.46 |
| South Carolina | Office $167.59 | Facility $111.73 |
| South Dakota** | Office $170.92 | Facility $110.46 |
| Southern Maine | Office $171.85 | Facility $111.94 |
| Stockton | Office $181.42 | Facility $115.16 |
| Suburban Chicago | Office $181.90 | Facility $119.81 |
| Tennessee | Office $164.58 | Facility $109.63 |
| Utah | Office $169.18 | Facility $112.35 |
| Vallejo | Office $203.21 | Facility $123.53 |
| Vermont | Office $171.06 | Facility $111.21 |
| Virgin Islands | Office $175.51 | Facility $114.38 |
| Virginia | Office $171.62 | Facility $112.19 |
| Visalia | Office $181.42 | Facility $115.16 |
| West Virginia | Office $166.37 | Facility $113.83 |
| Wisconsin | Office $167.31 | Facility $109.39 |
| Wyoming** | Office $173.21 | Facility $112.75 |
| Yuba City | Office $181.42 | Facility $115.16 |
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G0402 billing questions
How is G0402 different from the initial Annual Wellness Visit?
G0402 is the one-time Welcome to Medicare visit available during the first 12 months of Part B enrollment. G0438 reports the initial Annual Wellness Visit, a separate preventive benefit.
Can G0402 be reported again as an annual visit?
No. G0402 is a one-time benefit, not a recurring annual visit code. Use the applicable Annual Wellness Visit code for a qualifying later wellness visit.
How should an ECG furnished at the visit be reported?
Report the ECG using G0403 when the service includes the tracing, interpretation, and report. G0404 and G0405 identify the tracing and interpretation/report portions, respectively.
What documentation supports G0402?
Document the patient’s Part B enrollment timing and the visit elements performed, including history, health-risk and functional assessments, examination, counseling, and preventive-service recommendations.
Is G0402 selected by visit time?
No time threshold is used to distinguish G0402. Selection is based on the patient’s eligibility for the one-time benefit and the documented preventive-visit elements.
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.
15,228G0400,,Home sleep test/type 4 porta,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,229G0400,26,Home sleep test/type 4 porta,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,230G0400,TC,Home sleep test/type 4 porta,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,231G0402,,Initial preventive exam,A,,2.60,2.46,,0.65,,0.17,5.23,3.42,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,232G0403,,Ekg for initial prevent exam,A,,0.17,0.27,,0.27,NA,0.02,0.46,0.46,4,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,233G0404,,Ekg tracing for initial prev,A,,0.00,0.20,,0.20,NA,0.01,0.21,0.21,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,234G0405,,Ekg interpret & report preve,A,,0.17,0.07,,0.07,,0.01,0.25,0.25,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00