HCPCS G0081: Home care visitMedicare rate & RVUs in Oregon
Reports a 20-minute home-based care management visit for an established patient, with the service level supported by the encounter documentation.
Medicare pays $48.98–$51.26 for G0081 in the office in Oregon, from Rest Of Oregon to Portland. 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 G0081 covers
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.
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 G0081 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $51.26 | Unavailable |
| Rest Of Oregon | $48.98 | Unavailable |
How the G0081 rate is calculated
Each of G0081’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 · G0081
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.00Practice expense 0.44Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G0081
G0081 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 · G0081
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$49.43
Only one setting is priced for this code.
G0081 compared with similar codes
Compare codes
G0081 vs G0082 vs G0076 vs G0086: national Medicare rates
Swap in your local Medicare rate.
How to choose
- G0082Care management
- Use G0081 for the established-patient 20-minute level and G0082 for the 30-minute level.
- G0076Home care management
- The time level is 20 minutes for both codes; G0076 is for a new patient, while G0081 is for an established patient.
- G0086Care management
- 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.
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 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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