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CMS RVU26D · Effective 2026-10-01

G2004 Home visit Medicare reimbursement rates in Texas

Reports a 60-minute post-discharge home evaluation and management visit for a beneficiary who qualifies as a new patient. Compare G2004 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 G2004 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

$159.20–$166.26

8 of 8 localities have a supported rate.

Lowest: Beaumont

Highest: Houston

A spread of $7.06 per service.

Facility setting

No 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.

Find G2004 in your payment locality →

Where G2004 pays more and less in Texas

8 payment localities

$159.20 to $166.26

$159.20$162.73$166.26
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

Home-based evaluation and management

About G2004: Post-discharge home visit, new patient, 60 minutes

Reports a 60-minute post-discharge home evaluation and management visit for a beneficiary who qualifies as a new patient.

G2004 describes a home visit after a beneficiary’s discharge, with the service documented at the 60-minute level for a new patient. A physician or other qualified health care professional assesses the beneficiary in the residence, such as during recovery after a hospital stay. The encounter may address current symptoms, medication use, mobility, support at home, and the need for further care.

Choose the new-patient series when the beneficiary meets the applicable new-patient definition; use the established-patient series otherwise. Document the discharge context, home setting, new-patient status, time supporting the selected level, clinical assessment, and plan. CMS assigns the code work, practice-expense, and malpractice relative value units under the Physician Fee Schedule. G2003 and G2005 are the neighboring new-patient levels for 45 and 75 minutes, respectively.

Where the value comes from

  • Work RVU3.38 · 69%
  • Practice expense (office) RVU1.36 · 28%
  • Malpractice RVU0.16 · 3%

12

Medicare services in 2024 · #6155 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.

G2004 compared with similar codes

Office rates for Texas, from the same CMS release.

G2003

Home visit

New patient, 45 minutes

$117.10–$122.20

G2003 is the 45-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.

G2005

Home visit

New patient, 75 minutes

$210.02–$220.83

G2005 is the 75-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.

G2009

Home visit

Established patient, 60 minutes

$175.97–$185.81

G2009 is for an established patient at the 60-minute level. G2004 is the corresponding new-patient level.

Compare G2004 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

G2004 office and facility rates by payment locality
Payment localityOfficeFacility
Austin

Office

$165.92

Facility

Unavailable
Beaumont

Office

$159.20

Facility

Unavailable
Brazoria

Office

$162.98

Facility

Unavailable
Dallas

Office

$163.74

Facility

Unavailable
Fort Worth

Office

$163.36

Facility

Unavailable
Galveston

Office

$163.33

Facility

Unavailable
Houston

Office

$166.26

Facility

Unavailable
Rest Of Texas

Office

$160.83

Facility

Unavailable

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G2004 billing questions

When should G2004 be selected instead of G2009?

Use G2004 for a qualifying new patient and G2009 for an established patient when the post-discharge home visit is documented at the 60-minute level.

How does G2004 differ from G2003 and G2005?

Those codes are the neighboring new-patient post-discharge home-visit levels: G2003 is 45 minutes and G2005 is 75 minutes. Select the level supported by the documented service time.

What documentation supports G2004?

Record that the visit occurred at the beneficiary’s home after discharge, the beneficiary’s new-patient status, the time supporting the 60-minute level, and the assessment and plan.

Can G2004 be reported for a clinic follow-up?

No. G2004 identifies a post-discharge home visit; a clinic encounter is not the home service represented by this code.

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.

RVUs for G2004PPRRVU2026_Oct_nonQPP.csv, line 15,412 (RVU26D)