Both codes represent HIV PrEP counseling for 15–30 minutes. Choose G0011 when a physician furnishes the counseling; G0013 is for counseling furnished by clinical staff.
On this page
CMS RVU26D · Effective 2026-10-01
G0011 in Redding
Office / nonfacility
$30.28
Base rate per service
Facility setting
$21.86
Base rate per service
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.
Preventive counseling
About G0011: Physician HIV PrEP counseling
Report G0011 when a physician spends 15–30 minutes counseling a patient about HIV preexposure prophylaxis and reducing HIV acquisition risk.
A physician uses this service to counsel a patient about HIV preexposure prophylaxis (PrEP), including whether PrEP may fit the patient’s prevention needs, medication options, adherence, and risk-reduction strategies. It is relevant when a patient who may benefit from PrEP is considering it or needs counseling while using it. The service is typically furnished in an outpatient setting, such as a physician’s office.
Report G0011 for the physician’s 15–30 minutes of PrEP counseling, not for the medication injection itself. The record should identify the prevention counseling provided, the physician furnishing it, and the time spent. When an HIV PrEP injection is also given, G0012 represents that injection service; document each service performed. Use G0013 when the qualifying counseling is furnished by clinical staff rather than the physician.
Where the value comes from
- Work RVU0.45 · 51%
- Practice expense (office) RVU0.39 · 44%
- Malpractice RVU0.04 · 5%
26
Medicare services in 2024 · #5774 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.
G0011 compared with similar codes
Office rates for Redding, from the same CMS release.
G0012 represents an HIV PrEP drug injection, not counseling. G0011 is appropriate for the physician’s qualifying prevention counseling.
Prev med cnsl indiv apprx 15
99401 is individual preventive counseling of a general nature. G0011 specifically identifies physician counseling about HIV PrEP.
The same code, a different location
How does Redding compare?
In Bakersfield, the office rate for G0011 is $30.41—$0.13 higher than the $30.28 rate in Redding. Both use the same code, release and participation basis.
G0011 across payment areas
Same release and payment basis · bars start at $0
Redding · This locality
$30.28
$30.41
$0.13 higher than Redding
$30.28
The same base rate than Redding
$30.29
$0.01 higher than Redding
$30.28
The same base rate than Redding
$30.28
The same base rate than Redding
$1.66 higher than Redding
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
Across 109 of 109 CMS payment localities with a supported office rate, G0011 ranges from $26.91 in Arkansas to $37.15 in Alaska*. This is a geographic range, not an average.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · G0011
Office
$30.28
Facility
$21.86
The same base rate than Redding for the office setting.
Merced
California · G0011
Office
$30.28
Facility
$21.86
The same base rate than Redding for the office setting.
Modesto
California · G0011
Office
$30.28
Facility
$21.86
The same base rate than Redding for the office setting.
Napa
California · G0011
Office
$33.82
Facility
$23.70
$3.54 higher than Redding for the office setting.
Oxnard-Thousand Oaks-Ventura
California · G0011
Office
$31.68
Facility
$22.60
$1.40 higher than Redding for the office setting.
Rest Of California
California · G0011
Office
$30.28
Facility
$21.86
The same base rate than Redding for the office setting.
Riverside-San Bernardino-Ontario
California · G0011
Office
$30.72
Facility
$22.30
$0.44 higher than Redding for the office setting.
Sacramento-Roseville-Folsom
California · G0011
Office
$31.44
Facility
$22.50
$1.16 higher than Redding for the office setting.
Salinas
California · G0011
Office
$31.31
Facility
$22.41
$1.03 higher than Redding for the office setting.
San Diego-Chula Vista-Carlsbad
California · G0011
Office
$31.78
Facility
$22.60
$1.50 higher than Redding for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · G0011
Office
$35.44
Facility
$24.61
$5.16 higher than Redding for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · G0011
Office
$35.39
Facility
$24.56
$5.11 higher than Redding for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · G0011
Office
$36.18
Facility
$25.11
$5.90 higher than Redding for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · G0011
Office
$36.00
Facility
$24.92
$5.72 higher than Redding for the office setting.
San Luis Obispo-Paso Robles
California · G0011
Office
$30.84
Facility
$22.09
$0.56 higher than Redding for the office setting.
Santa Cruz-Watsonville
California · G0011
Office
$31.89
Facility
$22.56
$1.61 higher than Redding for the office setting.
Santa Maria-Santa Barbara
California · G0011
Office
$31.36
Facility
$22.40
$1.08 higher than Redding for the office setting.
Santa Rosa-Petaluma
California · G0011
Office
$32.19
Facility
$22.76
$1.91 higher than Redding for the office setting.
Stockton
California · G0011
Office
$30.28
Facility
$21.86
The same base rate than Redding for the office setting.
Vallejo
California · G0011
Office
$33.76
Facility
$23.63
$3.48 higher than Redding for the office setting.
Visalia
California · G0011
Office
$30.28
Facility
$21.86
The same base rate than Redding for the office setting.
Yuba City
California · G0011
Office
$30.28
Facility
$21.86
The same base rate than Redding for the office setting.
Dc + Md/Va Suburbs
District of Columbia · G0011
Office
$32.67
Facility
$23.62
$2.39 higher than Redding for the office setting.
Miami
Florida · G0011
Office
$31.97
Facility
$23.97
$1.69 higher than Redding for the office setting.
Chicago
Illinois · G0011
Office
$31.29
Facility
$23.57
$1.01 higher than Redding for the office setting.
Manhattan
New York · G0011
Office
$33.25
Facility
$24.32
$2.97 higher than Redding for the office setting.
Alaska*
Alaska · G0011
Office
$37.15
Facility
$28.97
$6.87 higher than Redding for the office setting.
Alabama
Alabama · G0011
Office
$27.18
Facility
$20.46
$3.10 lower than Redding for the office setting.
Arkansas
Arkansas · G0011
Office
$26.91
Facility
$20.31
$3.37 lower than Redding for the office setting.
Arizona
Arizona · G0011
Office
$28.80
Facility
$21.35
$1.48 lower than Redding for the office setting.
Colorado
Colorado · G0011
Office
$30.11
Facility
$21.94
$0.17 lower than Redding for the office setting.
Connecticut
Connecticut · G0011
Office
$30.98
Facility
$22.70
$0.70 higher than Redding for the office setting.
Delaware
Delaware · G0011
Office
$29.18
Facility
$21.59
$1.10 lower than Redding for the office setting.
Fort Lauderdale
Florida · G0011
Office
$30.64
Facility
$22.86
$0.36 higher than Redding for the office setting.
Rest Of Florida
Florida · G0011
Office
$29.49
Facility
$22.15
$0.79 lower than Redding for the office setting.
Atlanta
Georgia · G0011
Office
$29.91
Facility
$22.11
$0.37 lower than Redding for the office setting.
Rest Of Georgia
Georgia · G0011
Office
$28.24
Facility
$21.39
$2.04 lower than Redding for the office setting.
Hawaii, Guam
Hawaii · G0011
Office
$30.61
Facility
$21.88
$0.33 higher than Redding for the office setting.
Iowa
Iowa · G0011
Office
$27.48
Facility
$20.45
$2.80 lower than Redding for the office setting.
Idaho
Idaho · G0011
Office
$27.65
Facility
$20.58
$2.63 lower than Redding for the office setting.
East St. Louis
Illinois · G0011
Office
$29.71
Facility
$22.64
$0.57 lower than Redding for the office setting.
Rest Of Illinois
Illinois · G0011
Office
$29.01
Facility
$22.00
$1.27 lower than Redding for the office setting.
Suburban Chicago
Illinois · G0011
Office
$30.88
Facility
$22.99
$0.60 higher than Redding for the office setting.
Indiana
Indiana · G0011
Office
$27.76
Facility
$20.63
$2.52 lower than Redding for the office setting.
Kansas
Kansas · G0011
Office
$27.48
Facility
$20.53
$2.80 lower than Redding for the office setting.
Kentucky
Kentucky · G0011
Office
$27.83
Facility
$21.00
$2.45 lower than Redding for the office setting.
New Orleans
Louisiana · G0011
Office
$28.81
Facility
$21.58
$1.47 lower than Redding for the office setting.
Rest Of Louisiana
Louisiana · G0011
Office
$27.84
Facility
$21.04
$2.44 lower than Redding for the office setting.
Metropolitan Boston
Massachusetts · G0011
Office
$32.39
Facility
$23.22
$2.11 higher than Redding for the office setting.
Rest Of Massachusetts
Massachusetts · G0011
Office
$30.05
Facility
$21.96
$0.23 lower than Redding for the office setting.
Baltimore/Surr. Cntys
Maryland · G0011
Office
$30.90
Facility
$22.66
$0.62 higher than Redding for the office setting.
Rest Of Maryland
Maryland · G0011
Office
$29.59
Facility
$21.82
$0.69 lower than Redding for the office setting.
Rest Of Maine
Maine · G0011
Office
$27.85
Facility
$20.78
$2.43 lower than Redding for the office setting.
Southern Maine
Maine · G0011
Office
$28.78
Facility
$21.17
$1.50 lower than Redding for the office setting.
Detroit
Michigan · G0011
Office
$29.85
Facility
$22.44
$0.43 lower than Redding for the office setting.
Rest Of Michigan
Michigan · G0011
Office
$28.43
Facility
$21.42
$1.85 lower than Redding for the office setting.
Minnesota
Minnesota · G0011
Office
$28.83
Facility
$20.92
$1.45 lower than Redding for the office setting.
Metropolitan Kansas City
Missouri · G0011
Office
$28.57
Facility
$21.35
$1.71 lower than Redding for the office setting.
Metropolitan St. Louis
Missouri · G0011
Office
$28.77
Facility
$21.46
$1.51 lower than Redding for the office setting.
Rest Of Missouri
Missouri · G0011
Office
$27.56
Facility
$20.94
$2.72 lower than Redding for the office setting.
Mississippi
Mississippi · G0011
Office
$27.23
Facility
$20.62
$3.05 lower than Redding for the office setting.
Montana**
Montana · G0011
Office
$29.39
Facility
$21.71
$0.89 lower than Redding for the office setting.
North Carolina
North Carolina · G0011
Office
$28.04
Facility
$20.87
$2.24 lower than Redding for the office setting.
North Dakota**
North Dakota · G0011
Office
$28.60
Facility
$20.92
$1.68 lower than Redding for the office setting.
Nebraska
Nebraska · G0011
Office
$27.56
Facility
$20.47
$2.72 lower than Redding for the office setting.
New Hampshire
New Hampshire · G0011
Office
$29.76
Facility
$21.76
$0.52 lower than Redding for the office setting.
Northern Nj
New Jersey · G0011
Office
$32.51
Facility
$23.60
$2.23 higher than Redding for the office setting.
Rest Of New Jersey
New Jersey · G0011
Office
$31.32
Facility
$22.93
$1.04 higher than Redding for the office setting.
New Mexico
New Mexico · G0011
Office
$28.58
Facility
$21.54
$1.70 lower than Redding for the office setting.
Nevada**
Nevada · G0011
Office
$29.18
Facility
$21.49
$1.10 lower than Redding for the office setting.
Nyc Suburbs/Long Island
New York · G0011
Office
$33.96
Facility
$24.83
$3.68 higher than Redding for the office setting.
Poughkpsie/N Nyc Suburbs
New York · G0011
Office
$31.59
Facility
$23.18
$1.31 higher than Redding for the office setting.
Queens
New York · G0011
Office
$33.32
Facility
$24.24
$3.04 higher than Redding for the office setting.
Rest Of New York
New York · G0011
Office
$28.34
Facility
$21.05
$1.94 lower than Redding for the office setting.
Ohio
Ohio · G0011
Office
$28.27
Facility
$21.26
$2.01 lower than Redding for the office setting.
Oklahoma
Oklahoma · G0011
Office
$27.70
Facility
$20.84
$2.58 lower than Redding for the office setting.
Portland
Oregon · G0011
Office
$30.74
Facility
$22.20
$0.46 higher than Redding for the office setting.
Rest Of Oregon
Oregon · G0011
Office
$28.94
Facility
$21.29
$1.34 lower than Redding for the office setting.
Metropolitan Philadelphia
Pennsylvania · G0011
Office
$30.46
Facility
$22.46
$0.18 higher than Redding for the office setting.
Rest Of Pennsylvania
Pennsylvania · G0011
Office
$28.25
Facility
$21.20
$2.03 lower than Redding for the office setting.
Puerto Rico
Puerto Rico · G0011
Office
$29.52
Facility
$21.75
$0.76 lower than Redding for the office setting.
Rhode Island
Rhode Island · G0011
Office
$29.96
Facility
$22.03
$0.32 lower than Redding for the office setting.
South Carolina
South Carolina · G0011
Office
$28.20
Facility
$21.10
$2.08 lower than Redding for the office setting.
South Dakota**
South Dakota · G0011
Office
$28.51
Facility
$20.82
$1.77 lower than Redding for the office setting.
Tennessee
Tennessee · G0011
Office
$27.59
Facility
$20.61
$2.69 lower than Redding for the office setting.
Austin
Texas · G0011
Office
$30.03
Facility
$21.90
$0.25 lower than Redding for the office setting.
Beaumont
Texas · G0011
Office
$28.13
Facility
$21.13
$2.15 lower than Redding for the office setting.
Brazoria
Texas · G0011
Office
$29.10
Facility
$21.49
$1.18 lower than Redding for the office setting.
Dallas
Texas · G0011
Office
$29.29
Facility
$21.63
$0.99 lower than Redding for the office setting.
Fort Worth
Texas · G0011
Office
$29.17
Facility
$21.60
$1.11 lower than Redding for the office setting.
Galveston
Texas · G0011
Office
$29.19
Facility
$21.56
$1.09 lower than Redding for the office setting.
Houston
Texas · G0011
Office
$29.92
Facility
$22.30
$0.36 lower than Redding for the office setting.
Rest Of Texas
Texas · G0011
Office
$28.60
Facility
$21.31
$1.68 lower than Redding for the office setting.
Utah
Utah · G0011
Office
$28.47
Facility
$21.25
$1.81 lower than Redding for the office setting.
Virginia
Virginia · G0011
Office
$28.78
Facility
$21.23
$1.50 lower than Redding for the office setting.
Virgin Islands
United States Virgin Islands · G0011
Office
$29.52
Facility
$21.75
$0.76 lower than Redding for the office setting.
Vermont
Vermont · G0011
Office
$28.60
Facility
$21.00
$1.68 lower than Redding for the office setting.
Rest Of Washington
Washington · G0011
Office
$29.96
Facility
$21.87
$0.32 lower than Redding for the office setting.
Seattle (King Cnty)
Washington · G0011
Office
$32.86
Facility
$23.43
$2.58 higher than Redding for the office setting.
Wisconsin
Wisconsin · G0011
Office
$27.92
Facility
$20.56
$2.36 lower than Redding for the office setting.
West Virginia
West Virginia · G0011
Office
$28.26
Facility
$21.59
$2.02 lower than Redding for the office setting.
Wyoming**
Wyoming · G0011
Office
$29.05
Facility
$21.36
$1.23 lower than Redding for the office setting.
See how rates vary across the country
G0011 · 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.
$26.91
$37.15
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 | $37.15 | 1 |
| AL | $27.18 | 1 |
| AR | $26.91 | 1 |
| AZ | $28.80 | 1 |
| CA | $30.28–$36.18 | 29 |
| CO | $30.11 | 1 |
| CT | $30.98 | 1 |
| DC | $32.67 | 1 |
| DE | $29.18 | 1 |
| FL | $29.49–$31.97 | 3 |
| GA | $28.24–$29.91 | 2 |
| GU | $30.61 | 1 |
| HI | $30.61 | 1 |
| IA | $27.48 | 1 |
| ID | $27.65 | 1 |
| IL | $29.01–$31.29 | 4 |
| IN | $27.76 | 1 |
| KS | $27.48 | 1 |
| KY | $27.83 | 1 |
| LA | $27.84–$28.81 | 2 |
| MA | $30.05–$32.39 | 2 |
| MD | $29.59–$32.67 | 3 |
| ME | $27.85–$28.78 | 2 |
| MI | $28.43–$29.85 | 2 |
| MN | $28.83 | 1 |
| MO | $27.56–$28.77 | 3 |
| MS | $27.23 | 1 |
| MT | $29.39 | 1 |
| NC | $28.04 | 1 |
| ND | $28.60 | 1 |
| NE | $27.56 | 1 |
| NH | $29.76 | 1 |
| NJ | $31.32–$32.51 | 2 |
| NM | $28.58 | 1 |
| NV | $29.18 | 1 |
| NY | $28.34–$33.96 | 5 |
| OH | $28.27 | 1 |
| OK | $27.70 | 1 |
| OR | $28.94–$30.74 | 2 |
| PA | $28.25–$30.46 | 2 |
| PR | $29.52 | 1 |
| RI | $29.96 | 1 |
| SC | $28.20 | 1 |
| SD | $28.51 | 1 |
| TN | $27.59 | 1 |
| TX | $28.13–$30.03 | 8 |
| UT | $28.47 | 1 |
| VA | $28.78–$32.67 | 2 |
| VI | $29.52 | 1 |
| VT | $28.60 | 1 |
| WA | $29.96–$32.86 | 2 |
| WI | $27.92 | 1 |
| WV | $28.26 | 1 |
| WY | $29.05 | 1 |
Where does this rate apply?
Redding is a Medicare payment area. Our Census mapping connects it to 32 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Why are the office and facility amounts different?
For G0011 in Redding, the physician’s office rate is $30.28 and the facility-setting rate is $21.86: a difference of $8.42.
The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for G0011 in Redding. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$33.31
$30.28 × 110% = $33.31
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for G0011 in Redding.
PPRRVU2026_Oct_nonQPP.csv
15,017
- Code
- G0011
- Physician work
- 0.45
- Practice expense
- 0.39
- Malpractice
- 0.04
GPCI2026.csv
19
- Locality
- Redding
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.45 | × 1.017 | 0.4576 |
| Practice expense | 0.39 | × 1.096 | 0.4274 |
| Malpractice | 0.04 | × 0.536 | 0.0214 |
| Total RVUs | 0.9065 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Redding$30.28
Open G0011 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.45 | 1.017 |
| Practice expense | 0.39 | 1.096 |
| Malpractice | 0.04 | 0.536 |
(0.45 × 1.017 + 0.39 × 1.096 + 0.04 × 0.536) × $33.4009 = $30.28
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.45 | 1.017 |
| Practice expense | 0.16 | 1.096 |
| Malpractice | 0.04 | 0.536 |
(0.45 × 1.017 + 0.16 × 1.096 + 0.04 × 0.536) × $33.4009 = $21.86
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
G0011 · Office / nonfacility
$30.28
Effective 2026-10-01
The base rate is $3.13 higher than on 2025-10-01, moving from $27.15 to $30.28 (11.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$27.15changed to$30.28
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.33 changed to 0.39
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $27.15
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
G0011 billing questions
When should G0011 be chosen instead of G0013?
G0011 represents HIV PrEP counseling furnished by a physician for 15–30 minutes. G0013 is the corresponding counseling code when clinical staff furnish the service.
Does G0011 include a PrEP injection?
No. G0011 represents counseling; G0012 represents an HIV PrEP drug injection. Report each only when that service is actually furnished and documented.
What time should the record support?
Document 15–30 minutes spent on the physician’s HIV PrEP counseling. The record should make clear that the time relates to this counseling service.
Can G0011 be reported with G0012 on the same date?
They represent different services. If the physician provides qualifying counseling and an HIV PrEP injection is administered during the encounter, document both services.
How does G0011 differ from 99401?
G0011 specifically represents physician counseling about HIV PrEP. 99401 is a general individual preventive counseling code, rather than the HIV PrEP-specific service.
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.
