$166.58–$178.63
G0402 is the one-time Welcome to Medicare visit during the first 12 months of Part B enrollment. G0438 is the initial Annual Wellness Visit, a separate benefit.
On this page
CMS RVU26D · Effective 2026-10-01
G0402 Welcome visit Medicare reimbursement rates in Texas
G0402 reports Medicare’s one-time Welcome to Medicare visit, including a prevention-focused health review and examination during the initial Part B enrollment period. Compare G0402 office and facility rates across CMS payment localities in Texas.
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 G0402 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$166.89–$178.98
8 of 8 localities have a 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.
Where G0402 pays more and less in Texas
8 payment localities
$166.89 to $178.98
Preventive medicine
About G0402: Initial Medicare preventive physical examination
G0402 reports Medicare’s one-time Welcome to Medicare visit, including a prevention-focused health review and examination during the initial Part B enrollment period.
G0402 covers the one-time Welcome to Medicare visit, a prevention-focused review rather than a routine comprehensive physical. A physician or qualified nonphysician practitioner typically performs it in an office or outpatient setting. The clinician reviews medical and social history, assesses health risks, depression risk, functional ability and safety, performs an appropriate examination, and provides prevention counseling and a written screening schedule. Advance care planning may be discussed when the patient chooses to address it.
Report G0402 when the patient is within the first 12 months of Part B enrollment and the visit’s documented elements support the service. Record relevant history, risk and functional assessments, examination findings, counseling, and recommended preventive services. If a screening ECG is furnished, report the applicable ECG service separately using G0403 or its tracing and interpretation components, G0404 and G0405. The CMS facts provided list no special payment rules for G0402.
Where the value comes from
- Work RVU2.60 · 50%
- Practice expense (office) RVU2.46 · 47%
- Malpractice RVU0.17 · 3%
538K
Medicare services in 2024 · #217 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.
G0402 compared with similar codes
Office rates for Texas, from the same CMS release.
$131.08–$141.26
G0439 reports a subsequent Annual Wellness Visit. It is not used for the initial Welcome to Medicare service reported with G0402.
$14.51–$15.82
G0402 reports the preventive visit. G0403 reports the associated screening ECG service, including its tracing, interpretation, and report.
Compare G0402 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $178.98 | Facility $115.02 |
| Beaumont | Office $166.89 | Facility $111.87 |
| Brazoria | Office $173.39 | Facility $113.48 |
| Dallas | Office $174.33 | Facility $114.12 |
| Fort Worth | Office $173.59 | Facility $113.98 |
| Galveston | Office $173.83 | Facility $113.80 |
| Houston | Office $176.94 | Facility $116.91 |
| Rest Of Texas | Office $169.95 | Facility $112.57 |
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G0402 billing questions
How is G0402 different from the initial Annual Wellness Visit?
G0402 is the one-time Welcome to Medicare visit available during the first 12 months of Part B enrollment. G0438 reports the initial Annual Wellness Visit, a separate preventive benefit.
Can G0402 be reported again as an annual visit?
No. G0402 is a one-time benefit, not a recurring annual visit code. Use the applicable Annual Wellness Visit code for a qualifying later wellness visit.
How should an ECG furnished at the visit be reported?
Report the ECG using G0403 when the service includes the tracing, interpretation, and report. G0404 and G0405 identify the tracing and interpretation/report portions, respectively.
What documentation supports G0402?
Document the patient’s Part B enrollment timing and the visit elements performed, including history, health-risk and functional assessments, examination, counseling, and preventive-service recommendations.
Is G0402 selected by visit time?
No time threshold is used to distinguish G0402. Selection is based on the patient’s eligibility for the one-time benefit and the documented preventive-visit elements.
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.
15,228G0400,,Home sleep test/type 4 porta,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,229G0400,26,Home sleep test/type 4 porta,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,230G0400,TC,Home sleep test/type 4 porta,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,231G0402,,Initial preventive exam,A,,2.60,2.46,,0.65,,0.17,5.23,3.42,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,232G0403,,Ekg for initial prevent exam,A,,0.17,0.27,,0.27,NA,0.02,0.46,0.46,4,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,233G0404,,Ekg tracing for initial prev,A,,0.00,0.20,,0.20,NA,0.01,0.21,0.21,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,234G0405,,Ekg interpret & report preve,A,,0.17,0.07,,0.07,,0.01,0.25,0.25,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00