$61.54
G0513 covers the first 30-minute increment of prolonged preventive service; G0514 covers additional 30-minute increments.
On this page
CMS RVU26D · Effective 2026-10-01
G0513 Prolonged preventive care Medicare reimbursement rates in Nebraska
G0513 reports the first 30 minutes of preventive work that extends beyond the usual time for a Medicare annual wellness visit. Compare G0513 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 G0513 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
$61.54
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$48.59
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.
Preventive services
About G0513: Prolonged annual wellness visit services
G0513 reports the first 30 minutes of preventive work that extends beyond the usual time for a Medicare annual wellness visit.
G0513 captures additional direct work by a physician or other qualified health care professional when a Medicare annual wellness visit requires substantially more preventive service than the usual visit. Examples include extended discussion of screening needs, risk reduction, or a prevention plan during an initial or subsequent annual wellness visit. The added work must be preventive and distinct from the ordinary components of the visit; routine time spent completing the wellness visit itself is not prolonged service time.
Report G0513 as an add-on with the primary preventive service, commonly the initial or subsequent annual wellness visit, G0438 or G0439. Documentation should identify the preventive work performed and the time beyond the usual service that supports the first 30-minute increment. G0513 is not a stand-alone service. Under the CMS rule provided, it is paid within the primary procedure's global period. For additional prolonged time, G0514 is the related additional-time code.
CMS billing rules for G0513
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU1.17 · 60%
- Practice expense (office) RVU0.70 · 36%
- Malpractice RVU0.07 · 4%
22.8K
Medicare services in 2024 · #1091 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.
G0513 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$164.52
G0438 reports the initial annual wellness visit itself. G0513 is an add-on for qualifying preventive work beyond the usual visit.
$129.59
G0439 reports a subsequent annual wellness visit. G0513 reports additional prolonged preventive work when paired with the primary service.
99417
No office rateProlng op e/m each 15 min
99417 is associated with prolonged office or outpatient E/M services; G0513 is for prolonged preventive service, commonly with an annual wellness visit.
Compare G0513 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
$61.54
Facility
$48.59
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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 G0513 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
15,309
- Code
- G0513
- Physician work
- 1.17
- Practice expense
- 0.70
- Malpractice
- 0.07
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.17 | × 1.000 | 1.1700 |
| Practice expense | 0.70 | × 0.923 | 0.6461 |
| Malpractice | 0.07 | × 0.378 | 0.0265 |
| Total RVUs | 1.8426 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$61.54
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 0.7 | 0.923 |
| Malpractice | 0.07 | 0.378 |
(1.17 × 1 + 0.7 × 0.923 + 0.07 × 0.378) × $33.4009 = $61.54
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 0.28 | 0.923 |
| Malpractice | 0.07 | 0.378 |
(1.17 × 1 + 0.28 × 0.923 + 0.07 × 0.378) × $33.4009 = $48.59
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.
G0513 billing questions
Which annual wellness visit codes are paired with G0513?
G0513 is commonly paired with G0438 for an initial annual wellness visit or G0439 for a subsequent annual wellness visit. It reports qualifying preventive work beyond the usual visit.
Can G0513 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure. CMS pays it within that procedure's global period.
When should G0514 be used instead?
G0513 represents the first 30-minute increment of prolonged preventive service. G0514 is the related code for additional 30-minute increments.
What documentation supports G0513?
Document the preventive work beyond the usual annual wellness visit and the time attributable to that additional work. The record should distinguish it from time spent on routine visit elements.
Is G0513 the prolonged-service code for a regular office E/M visit?
No. G0513 is for prolonged preventive service, commonly with an annual wellness visit. Prolonged office or outpatient E/M work uses a different code family when applicable.
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.
15,306G0506,,Comp asses care plan ccm svc,A,,0.87,1.06,,0.22,,0.06,1.99,1.15,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,307G0508,,Crit care telehea consult 60,A,,4.00,1.17,NA,1.17,,0.36,5.53,5.53,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,308G0509,,Crit care telehea consult 50,A,,3.86,1.06,NA,1.06,,0.36,5.28,5.28,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,309G0513,,"Prolong prev svcs, first 30m",A,,1.17,0.70,,0.28,,0.07,1.94,1.52,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,310G0514,,"Prolong prev svcs, addl 30m",A,,1.17,0.70,,0.28,,0.07,1.94,1.52,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,311G0516,,"Insert drug del implant, >=4",A,,1.77,3.32,,0.62,,0.15,5.24,2.54,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,312G0517,,Remove drug implant,A,,2.05,3.71,,0.68,,0.18,5.94,2.91,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,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