$53.17
G0180 reports initial home health certification. G0454 reports the physician’s documentation of an NPP encounter connected with certification.
On this page
CMS RVU26D · Effective 2026-10-01
G0454 NPP documentation Medicare reimbursement rates in Nebraska
Reports a physician’s documentation of an eligible nonphysician practitioner’s face-to-face encounter used to support Medicare home health certification. Compare G0454 office and facility rates across CMS payment localities in Nebraska.
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 G0454 in Nebraska?
Nebraska 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
$8.60
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$7.37
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
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.
Home health services
About G0454: NPP encounter documentation for home health
Reports a physician’s documentation of an eligible nonphysician practitioner’s face-to-face encounter used to support Medicare home health certification.
G0454 represents the physician’s documentation of a face-to-face encounter performed by a nonphysician practitioner (NPP) in connection with Medicare home health certification. The NPP encounter provides clinical information for the physician’s certification decision; G0454 is not the NPP’s ordinary evaluation-and-management visit. The work belongs to the home health certification process, not to a separate office visit simply because the encounter occurred in an office.
Report G0454 when the physician documents the qualifying NPP encounter for the home health certification. The record should identify the encounter and include the clinical findings the physician used in documenting the certification. G0454 is distinct from the code for the certification itself: report the applicable certification code when its requirements are met. The supplied CMS fee-schedule facts assign work and practice-expense relative value units to G0454 and list no additional payment rules for this code.
Where the value comes from
- Work RVU0.18 · 67%
- Practice expense (office) RVU0.08 · 30%
- Malpractice RVU0.01 · 4%
1.9K
Medicare services in 2024 · #2487 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.
G0454 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$41.59
G0179 reports home health recertification, not the physician’s documentation of an NPP face-to-face encounter.
$89.57
99213 reports an established-patient office or outpatient E/M service. G0454 concerns physician documentation of an NPP encounter for home health certification.
Compare G0454 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
Nebraska →
Office / nonfacility
$8.60
Facility
$7.37
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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 G0454 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
15,274
- Code
- G0454
- Physician work
- 0.18
- Practice expense
- 0.08
- Malpractice
- 0.01
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.18 | × 1.000 | 0.1800 |
| Practice expense | 0.08 | × 0.923 | 0.0738 |
| Malpractice | 0.01 | × 0.378 | 0.0038 |
| Total RVUs | 0.2576 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$8.60
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.18 | 1 |
| Practice expense | 0.08 | 0.923 |
| Malpractice | 0.01 | 0.378 |
(0.18 × 1 + 0.08 × 0.923 + 0.01 × 0.378) × $33.4009 = $8.60
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.18 | 1 |
| Practice expense | 0.04 | 0.923 |
| Malpractice | 0.01 | 0.378 |
(0.18 × 1 + 0.04 × 0.923 + 0.01 × 0.378) × $33.4009 = $7.37
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.
G0454 billing questions
What kind of NPP encounter supports G0454?
It is the face-to-face encounter performed by an NPP in connection with Medicare home health certification. The physician documents that encounter for the certification record.
Is G0454 the NPP’s evaluation-and-management visit?
No. G0454 represents the physician’s documentation of the NPP encounter, rather than the NPP’s patient visit service.
How does G0454 differ from G0180?
G0454 represents documentation of the NPP encounter. G0180 represents initial certification of Medicare-covered home health services.
What should the physician’s documentation show?
The record should identify the NPP encounter and preserve the clinical findings the physician used in documenting the home health certification.
Is G0454 the code for home health recertification?
No. G0179 represents recertification; G0454 represents physician documentation of an NPP encounter in the home health certification process.
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.
15,271G0452,26,Molecular pathology interpr,A,,0.91,0.39,,0.39,,0.01,1.31,1.31,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,272G0452,TC,Molecular pathology interpr,A,,0.00,0.08,,0.08,NA,0.01,0.09,0.09,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,273G0453,,Cont intraop neuro monitor,A,,0.60,0.17,NA,0.17,,0.05,0.82,0.82,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,274G0454,,Md document visit by npp,A,,0.18,0.08,,0.04,,0.01,0.27,0.23,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,275G0455,,Fecal microbiota prep instil,A,,1.31,2.93,,0.39,,0.14,4.38,1.84,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,276G0458,,Ldr prostate brachy comp rat,E,,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
15,277G0459,,Telehealth inpt pharm mgmt,A,,0.95,0.18,NA,0.18,,0.06,1.19,1.19,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068