$77.70
Use G0081 for the established-patient 20-minute level and G0082 for the 30-minute level.
On this page
CMS RVU26D · Effective 2026-10-01
G0081 Home care visit Medicare reimbursement rates in Kentucky
Reports a 20-minute home-based care management visit for an established patient, with the service level supported by the encounter documentation. Compare G0081 office and facility rates across CMS payment localities in Kentucky.
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 G0081 in Kentucky?
Kentucky 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
$47.69
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Care management
About G0081: Established patient home care management visit
Reports a 20-minute home-based care management visit for an established patient, with the service level supported by the encounter documentation.
G0081 describes a care management visit in the established patient's home at the 20-minute level. The clinician addresses the patient's ongoing care needs during an in-home encounter, such as reviewing the current management approach and coordinating care. The code is distinct from a home care-plan service and from a routine office visit; the record should make clear that the encounter occurred in the home and involved care management.
Select G0081 when the patient is established and the documented service supports this 20-minute level. Record the patient's established status, home setting, work performed, and time attributable to the service. CMS assigns the code work, practice-expense, and malpractice relative value units under the physician fee schedule. The submitted record should support the selected time level; the descriptor alone does not establish additional units.
Where the value comes from
- Work RVU1.00 · 68%
- Practice expense (office) RVU0.44 · 30%
- Malpractice RVU0.04 · 3%
57
Medicare services in 2024 · #5277 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.
G0081 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$47.73
The time level is 20 minutes for both codes; G0076 is for a new patient, while G0081 is for an established patient.
$70.34
G0086 identifies a home care-plan service at the 30-minute level. G0081 identifies an established-patient care management home visit at the 20-minute level.
Compare G0081 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
Kentucky →
Office / nonfacility
$47.69
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 G0081 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
15,073
- Code
- G0081
- Physician work
- 1.00
- Practice expense
- 0.44
- Malpractice
- 0.04
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.00 | × 1.000 | 1.0000 |
| Practice expense | 0.44 | × 0.889 | 0.3912 |
| Malpractice | 0.04 | × 0.915 | 0.0366 |
| Total RVUs | 1.4278 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$47.69
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1 | 1 |
| Practice expense | 0.44 | 0.889 |
| Malpractice | 0.04 | 0.915 |
(1 × 1 + 0.44 × 0.889 + 0.04 × 0.915) × $33.4009 = $47.69
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.
G0081 billing questions
How does G0081 differ from G0082?
Both describe care management home visits for established patients. G0081 is the 20-minute level; G0082 is the 30-minute level.
Can G0081 be used for a new patient?
No. G0081 is for an established patient. The corresponding 20-minute new-patient home visit code is G0076.
What time should the record support?
Document the time attributable to the care management service and the work performed during the home visit. The code identifies the 20-minute level.
How is G0081 different from G0086?
G0081 identifies a care management home visit for an established patient. G0086 describes a home care-plan service, so choose based on the service documented rather than treating the codes as interchangeable.
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.
15,070G0078,,Care manag h vst new pt 45 m,A,,2.53,0.95,,0.95,NA,0.12,3.60,3.60,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,071G0079,,Care manag h vst new pt 60 m,A,,3.38,1.36,,1.36,NA,0.16,4.90,4.90,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,072G0080,,Care manag h vst new pt 75 m,A,,4.09,2.16,,2.16,NA,0.25,6.50,6.50,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,073G0081,,Care man h v ext pt 20 mi,A,,1.00,0.44,,0.44,NA,0.04,1.48,1.48,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,074G0082,,Care man h v ext pt 30 m,A,,1.56,0.79,,0.79,NA,0.07,2.42,2.42,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,075G0083,,Care man h v ext pt 45 m,A,,2.33,1.36,,1.36,NA,0.16,3.85,3.85,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,076G0084,,Care man h v ext pt 60 m,A,,3.28,1.94,,1.94,NA,0.24,5.46,5.46,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631