$27.18
Use G0011 for qualifying HIV PrEP counseling by a physician or other qualified health care professional; use G0012 for administering the injectable PrEP medication.
On this page
CMS RVU26D · Effective 2026-10-01
G0012 PrEP injection Medicare reimbursement rates in Alabama
Report G0012 for administering injectable HIV pre-exposure prophylaxis, such as long-acting cabotegravir, under physician supervision. Compare G0012 office and facility rates across CMS payment localities in Alabama.
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 G0012 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$14.05
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
HIV prevention
About G0012: Injectable HIV PrEP administration
Report G0012 for administering injectable HIV pre-exposure prophylaxis, such as long-acting cabotegravir, under physician supervision.
G0012 represents the clinical service of administering an injectable medication for HIV pre-exposure prophylaxis. It is used when a patient receives a prescribed PrEP injection to reduce the risk of acquiring HIV; long-acting cabotegravir is a common example. The injection is generally given by clinical staff in a medical office or clinic as part of the patient’s PrEP care.
Report G0012 for the administration service, not for counseling alone. When the drug product is separately reportable, identify it with its applicable drug code; for cabotegravir, that may include J0739. The record should support that an injectable PrEP medication was administered, with the medication and administration documented. CMS identifies this as an incident-to service: bill it only when performed under physician supervision.
CMS billing rules for G0012
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.17 · 37%
- Practice expense (office) RVU0.28 · 61%
- Malpractice RVU0.01 · 2%
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.
G0012 compared with similar codes
Office rates for Alabama, from the same CMS release.
$21.98
G0013 describes qualifying HIV PrEP counseling by clinical staff, not the injection service represented by G0012.
J0739
No office rateHiv prep, inj, cabotegravir
J0739 identifies cabotegravir by drug quantity; G0012 represents the administration service.
Compare G0012 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.
1 of 1 payment localities
Alabama →
Office / nonfacility
$14.05
Facility
Unavailable
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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 G0012 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
15,018
- Code
- G0012
- Physician work
- 0.17
- Practice expense
- 0.28
- Malpractice
- 0.01
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.17 | × 1.000 | 0.1700 |
| Practice expense | 0.28 | × 0.875 | 0.2450 |
| Malpractice | 0.01 | × 0.566 | 0.0057 |
| Total RVUs | 0.4207 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$14.05
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.17 | 1 |
| Practice expense | 0.28 | 0.875 |
| Malpractice | 0.01 | 0.566 |
(0.17 × 1 + 0.28 × 0.875 + 0.01 × 0.566) × $33.4009 = $14.05
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.
G0012 billing questions
How is G0012 different from G0011?
G0012 represents administration of an injectable HIV PrEP medication. G0011 is for qualifying HIV PrEP counseling by a physician or other qualified health care professional.
How is G0012 different from G0013?
G0012 covers the injection service. G0013 is for qualifying HIV PrEP counseling furnished by clinical staff.
Can the drug product be reported separately?
Report the drug product separately when applicable and separately reportable. For cabotegravir, J0739 may identify the drug; G0012 represents its administration.
What supervision is required for billing G0012?
CMS identifies G0012 as an incident-to service, so it may be billed only when performed under physician supervision.
What should the record document?
Document that an injectable medication for HIV PrEP was administered and identify the medication given. The service must also meet the physician-supervision condition for incident-to billing.
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.
15,015G0009,,Admin pneumococcal vaccine,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,016G0010,,Admin hepatitis b vaccine,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,017G0011,,"Hiv prep counsel, md 15-30m",A,,0.45,0.39,,0.16,,0.04,0.88,0.65,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,018G0012,,Injection of hiv prep drug,A,,0.17,0.28,,0.28,NA,0.01,0.46,0.46,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,019G0013,,"Hiv prep counsel, clin staff",A,,0.18,0.54,,0.04,,0.01,0.73,0.23,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,020G0017,,Crisis psychotherapy 60m,A,,4.70,1.79,,0.40,,0.05,6.54,5.15,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,021G0018,,Crisis psychotherapy add 30m,A,,2.25,0.87,,0.21,,0.03,3.15,2.49,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515