HCPCS G0427: Telehealth consultMedicare rate & RVUs in Utah
Report G0427 for a high-level telehealth consultation with a patient in an emergency department or at the initial inpatient stage, typically lasting 70 minutes.
CMS doesn’t publish an office rate for G0427 in Utah.
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 G0427 covers
G0427 represents a high-level remote consultation for a patient in an emergency department or during the initial inpatient stage. A consulting physician or other qualified practitioner evaluates the patient by telehealth, reviews relevant records, and provides assessment and recommendations to the treating team. A common clinical situation is a remote specialist assessing a patient whose condition requires expertise not immediately available at the hospital, such as a neurologic emergency.
Select this level within the G0425–G0427 series when the documented consultation supports the highest service level, typically associated with 70 minutes. The record should describe the patient’s clinical problem, the consultant’s evaluation and decision-making, and the recommendations communicated to the treating team; document time when it supports the selected level. G0427 describes the consultation itself, rather than a later inpatient follow-up encounter.
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.
G0427 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $165.58 |
How the G0427 rate is calculated
Each of G0427’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 · G0427
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.86Practice expense 0.90Malpractice 0.28
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G0427
G0427 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 · G0427
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
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G0427 isn’t priced in this setting.
G0427 compared with similar codes
Compare codes
G0427 vs G0425 vs G0426 vs G0406: national Medicare rates
Swap in your local Medicare rate.
How to choose
- G0425Hospital teleconsult
- G0425 is the lower-level emergency department or initial inpatient telehealth consultation, typically associated with 30 minutes; G0427 is the highest level, typically associated with 70 minutes.
- G0426Teleconsultation
- G0426 represents the intermediate level in the same consultation series, typically associated with 50 minutes. Choose G0427 for the higher-level service typically associated with 70 minutes.
- G0406Inpatient follow-up
- G0406 describes an inpatient telehealth follow-up consultation. G0427 is for an emergency department or initial inpatient consultation, not a later follow-up.
G0427 billing questions
How does G0427 differ from G0425 and G0426?
All three describe telehealth consultations for emergency department or initial inpatient patients. G0427 is the highest level in this series and is typically associated with 70 minutes; G0425 and G0426 represent lower levels.
Does the record need to support 70 minutes?
The service is typically associated with 70 minutes. Document the consultation and its duration when time supports selection of G0427, along with the clinical assessment and recommendations.
Can G0427 describe an inpatient follow-up consultation?
G0427 is for an emergency department or initial inpatient consultation. Inpatient follow-up telehealth consultations are represented by a separate code series, including G0406 through G0408.
What documentation supports G0427?
Include the reason for the consultation, the consultant’s evaluation and clinical decision-making, relevant record review, and recommendations communicated to the treating team. Document time when it supports the selected level.
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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