HCPCS G0296: LDCT counselingMedicare rate & RVUs in Oregon
Report G0296 for the face-to-face visit that assesses Medicare lung cancer screening eligibility and supports a shared decision about low-dose CT screening.
Medicare pays $28.39–$29.90 for G0296 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 G0296 covers
G0296 represents a face-to-face counseling and shared decision-making visit to determine whether a patient should undergo lung cancer screening with low-dose CT (LDCT). A physician or qualified nonphysician practitioner typically conducts the visit in an office or outpatient setting. The patient must be asymptomatic and meet Medicare screening criteria, including age 50 through 77, at least a 20 pack-year smoking history, and current smoking or quitting within the past 15 years. The discussion addresses screening benefits and harms, the importance of annual adherence, the effect of comorbidities, and willingness to pursue evaluation and treatment if needed.
Report G0296 for the eligibility and decision visit, not for image acquisition; report 71271 for the screening CT. Documentation should support the patient’s age and smoking history, absence of lung cancer symptoms, eligibility assessment, use of a decision aid, and shared decision-making discussion. Include documentation of smoking cessation or abstinence counseling as appropriate. The code is associated with the initial screening decision visit before the first LDCT; it does not describe the scan itself.
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 G0296 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $29.90 | $22.84 |
| Rest Of Oregon | $28.39 | $22.06 |
How the G0296 rate is calculated
Each of G0296’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 · G0296
RVUs × geographic indexes × conversion factor
Work0.52
0.52 RVUs× 1.000 GPCI
Practice expense0.31
0.31 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
0.8600
Conversion factor
$33.4009
Medicare rate
$28.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0296
G0296 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 · G0296
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$28.72
- Non-facility (office)
- $28.72
- Facility
- $22.38
Higher because the practice carries its own overhead.
G0296 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 71271Lung screening CT
- 71271 reports the screening CT acquisition; G0296 reports the preceding eligibility and shared decision-making visit.
- 99406Smoking cessation
- 99406 is for smoking and tobacco-use cessation counseling. It does not capture the LDCT eligibility assessment and shared decision-making service.
- 99407Smoking cessation
- 99407 reports a longer smoking and tobacco-use cessation counseling service, not the Medicare LDCT eligibility visit represented by G0296.
G0296 billing questions
Does G0296 include the low-dose CT scan?
No. G0296 describes the eligibility and shared decision-making visit. The screening CT is reported separately with 71271.
Which patients meet the Medicare screening criteria?
The patient must be asymptomatic, age 50 through 77, have at least a 20 pack-year smoking history, and currently smoke or have quit within the past 15 years.
What documentation supports G0296?
Record the patient’s age, smoking and quit history, lack of symptoms, eligibility assessment, decision-aid use, and discussion of screening benefits, harms, adherence, comorbidities, and willingness to pursue treatment.
Is G0296 reported for every annual screening CT?
G0296 describes the initial eligibility and shared decision-making visit before the first screening LDCT. It is not the code for subsequent annual scans.
Can smoking cessation counseling codes replace G0296?
No. Codes 99406 and 99407 describe smoking and tobacco-use cessation counseling; they do not represent the full LDCT eligibility assessment and shared decision-making visit.
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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