HCPCS G2251: Virtual check-inMedicare rate & RVUs in Illinois
A qualified health care professional who cannot report E/M services uses G2251 for a 5-10-minute medical discussion with an established patient.
Medicare pays $13.75–$14.55 for G2251 in the office in Illinois, from Rest Of Illinois to Chicago. Which amount applies depends on the service address.
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 G2251 covers
G2251 covers a brief, live communication with an established patient about a medical concern, such as discussing a new symptom or a question about an ongoing treatment plan. The discussion must total 5-10 minutes. The service is performed by a qualified health care professional who cannot report evaluation and management services; eligible nonphysician practitioners may include therapists or other clinicians working within their Medicare benefit and scope.
Report G2251 only when the discussion meets the time and practitioner criteria and is not part of a related service in the preceding 7 days or followed by a related service or procedure within 24 hours or the soonest available appointment. Document the communication method, medical issue addressed, discussion time, and why the contact was distinct from related care. CMS assigns G2251 its own physician fee schedule values. Choose G2012 for the comparable 5-10-minute check-in when the practitioner can report E/M services, or G2252 for that practitioner’s longer check-in.
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 G2251 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.
4 payment localities
$13.75 to $14.55
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $14.55 | $11.19 |
| East St. Louis | $13.94 | $10.87 |
| Rest Of Illinois | $13.75 | $10.70 |
| Suburban Chicago | $14.49 | $11.06 |
How the G2251 rate is calculated
Each of G2251’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 · G2251
RVUs × geographic indexes × conversion factor
Work0.25
0.25 RVUs× 1.000 GPCI
Practice expense0.16
0.16 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.4200
Conversion factor
$33.4009
Medicare rate
$14.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G2251
G2251 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 · G2251
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$14.03
- Non-facility (office)
- $14.03
- Facility
- $10.69
Higher because the practice carries its own overhead.
G2251 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G2252Virtual check-in
- G2252 covers an 11-20-minute check-in by a physician or QHP who can report E/M services. G2251 is the 5-10-minute service for a QHP who cannot report E/M services.
- G2250Remote image review
- G2250 concerns review of patient-submitted images or video; G2251 requires a medical discussion with the patient.
- 99421Online E/M
- 99421 is an online digital E/M service based on patient-initiated portal communication and cumulative time. G2251 is a 5-10-minute medical discussion by a QHP who cannot report E/M services.
G2251 billing questions
Who should report G2251 instead of G2012?
G2251 is for a qualified health care professional who cannot report E/M services. G2012 covers the comparable 5-10-minute check-in when the practitioner can report E/M services.
How much discussion time supports G2251?
Document 5-10 minutes of medical discussion with the established patient. The code is not selected by adding unrelated record review or administrative work to the discussion.
Can G2251 be reported when the contact leads to an office visit?
Not when the check-in leads to a related service or procedure within 24 hours or the soonest available appointment. A related service in the preceding 7 days also affects whether G2251 fits.
How is G2251 different from G2250?
G2251 describes a brief medical discussion. G2250 is for a practitioner’s review and interpretation of images or video submitted by the patient.
When is G2252 a better fit?
G2252 is for an 11-20-minute check-in by a physician or other qualified health care professional who can report E/M services. G2251 is limited to 5-10 minutes and a QHP who cannot report E/M services.
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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