No office rate
Both describe an initial hospital teleconsultation, but G0426 is the typically 50-minute level; G0425 is the typically 30-minute level.
On this page
CMS RVU26D · Effective 2026-10-01
G0425 Hospital teleconsult Medicare reimbursement rates in Georgia
Report G0425 for an initial remote physician consultation with a patient in an emergency department or inpatient setting, typically lasting 30 minutes. Compare G0425 office and facility rates across CMS payment localities in Georgia.
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 G0425 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$83.91–$85.86
2 of 2 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.
Telehealth consultation
About G0425: Initial hospital telehealth consultation
Report G0425 for an initial remote physician consultation with a patient in an emergency department or inpatient setting, typically lasting 30 minutes.
G0425 represents an initial physician consultation conducted by telehealth while the patient is in an emergency department or hospital inpatient setting. A distant-site specialist may assess an acute problem, review available clinical information, and provide recommendations to the treating team; a neurologist evaluating possible stroke in a community emergency department is a common example. The service is distinct from a later hospital follow-up visit. The consultation is conducted through a live telehealth connection with the patient at the hospital.
Select G0425 when the documented consultation corresponds to the typically 30-minute level; G0426 and G0427 describe longer levels. Record the consultation request, patient setting, telehealth interaction, clinical assessment, recommendations, and time supporting the selected level. CMS assigns work, practice-expense, and malpractice relative value units to this service under the Physician Fee Schedule. The assessment and recommendations are part of the consultation; the code represents the initial consultation encounter.
Where the value comes from
- Work RVU1.92 · 76%
- Practice expense (office) RVU0.41 · 16%
- Malpractice RVU0.19 · 8%
31.5K
Medicare services in 2024 · #955 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.
G0425 compared with similar codes
Office rates for Georgia, from the same CMS release.
No office rate
G0427 is the longer, typically 70-minute initial hospital teleconsultation level. G0425 is the typically 30-minute level.
No office rate
G0407 is for inpatient telehealth follow-up, typically 25 minutes. G0425 is for the initial consultation in an emergency department or inpatient setting.
No office rate
G0408 describes inpatient telehealth follow-up, typically 35 minutes; G0425 describes an initial hospital teleconsultation, typically 30 minutes.
Compare G0425 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.
2 of 2 payment localities
Atlanta →
Office / nonfacility
Unavailable
Facility
$85.86
Rest Of Georgia →
Office / nonfacility
Unavailable
Facility
$83.91
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G0425 billing questions
When should G0425 be used instead of G0426 or G0427?
Use G0425 for the initial hospital teleconsultation at the typically 30-minute level. G0426 and G0427 represent longer consultation levels, so the documented time and service should support the code selected.
Can G0425 be reported for a hospital follow-up?
G0425 describes an initial consultation. Subsequent inpatient telehealth follow-up services are represented by codes such as G0407 and G0408.
Does the patient need to be in a hospital setting?
Yes. G0425 is for an initial telehealth consultation when the patient is in an emergency department or inpatient setting, not a routine office telehealth visit.
What should the consultation note document?
Document the hospital setting, reason for the consultation, telehealth interaction, clinical findings, recommendations to the treating team, and time supporting the selected service level.
Who reports G0425?
The distant-site physician furnishing the initial consultation reports the service. The record should identify the consulting clinician and the hospital-based patient encounter.
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.
15,249G0421,,Ed svc ckd grp per session,A,,0.50,0.29,,0.29,NA,0.03,0.82,0.82,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,250G0422,,Intens cardiac rehab w/exerc,A,,2.05,1.77,,1.77,,0.12,3.94,3.94,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,251G0423,,Intens cardiac rehab no exer,A,,2.05,1.77,,1.77,,0.12,3.94,3.94,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,252G0425,,Inpt/ed teleconsult30,A,,1.92,0.41,NA,0.41,,0.19,2.52,2.52,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,253G0426,,Inpt/ed teleconsult50,A,,2.61,0.67,NA,0.67,,0.23,3.51,3.51,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,254G0427,,Inpt/ed teleconsult70,A,,3.86,0.90,NA,0.90,,0.28,5.04,5.04,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,255G0428,,Collagen meniscus implant,N,,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