HCPCS G0407: Inpatient follow-upMedicare rate & RVUs in Illinois
Reports a physician’s subsequent inpatient telehealth consultation at the 25-minute level for reassessing a hospitalized patient after an earlier consultation.
CMS doesn’t publish an office rate for G0407 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What G0407 covers
G0407 represents a physician’s follow-up consultation with a hospitalized patient by telehealth, at a service level typically involving about 25 minutes. A consulting physician, often a specialist, may reassess the patient’s course, review new clinical information, and discuss recommendations with the patient and inpatient team. The code is for a subsequent consultation, not the initial inpatient or emergency department teleconsultation.
Select this level when the documented follow-up service supports the 25-minute level. The record should establish that the encounter was a telehealth follow-up, describe the clinical reassessment and recommendations, and support the time associated with the service. CMS assigns the service a physician fee schedule valuation. The code represents the follow-up consultation as a service; document the work performed rather than treating each discussion or review as a separate unit.
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 G0407 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $69.38 |
| East St. Louis | Unavailable | $66.79 |
| Rest Of Illinois | Unavailable | $64.89 |
| Suburban Chicago | Unavailable | $67.58 |
How the G0407 rate is calculated
Each of G0407’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.
How the rate is built · G0407
RVUs × geographic indexes × conversion factor
Work1.39
1.39 RVUs× 1.000 GPCI
Practice expense0.40
0.40 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
1.9100
Conversion factor
$33.4009
Medicare rate
$63.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0407
G0407 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · G0407
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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G0407 isn’t priced in this setting.
G0407 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0406Inpatient follow-up
- Both represent inpatient telehealth follow-up consultations. G0406 is the shorter service level; G0407 is typically 25 minutes.
- G0408Inpatient follow-up
- Both represent inpatient telehealth follow-up consultations. G0408 is the longer service level; G0407 is typically 25 minutes.
- G0425Hospital teleconsult
- G0425 is an initial inpatient or emergency department teleconsultation. G0407 is for a subsequent inpatient follow-up consultation.
G0407 billing questions
When should G0407 be used instead of G0425, G0426, or G0427?
G0407 is for a follow-up inpatient telehealth consultation. G0425, G0426, and G0427 describe initial inpatient or emergency department teleconsultations at different service levels.
How does G0407 differ from G0406 and G0408?
These are follow-up inpatient telehealth consultation levels. G0406 is the shorter level, G0407 is typically 25 minutes, and G0408 is the longer level.
What documentation supports G0407?
Document the follow-up nature of the consultation, the patient’s clinical status and reassessment, recommendations, telehealth delivery, and time supporting this level.
Is G0407 reported in 25-minute units?
The code identifies a follow-up service level typically involving 25 minutes; it is not a code for each separate 25-minute increment.
Can G0407 represent the first inpatient telehealth consultation?
No. Use an initial inpatient or emergency department teleconsultation code when the service is the initial consultation; G0407 identifies follow-up care.
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
Show the CMS file lines behind this rate
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