HCPCS G0506: CCM care planningMedicare rate & RVUs in Utah
Report G0506 when a physician or qualified health professional performs an extensive chronic care assessment and develops a care plan beyond the associated E/M service.
Medicare pays $64.14 for G0506 in the office in Utah (Utah). 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 G0506 covers
G0506 represents in-depth assessment and care planning for a patient with chronic conditions who is starting chronic care management. A physician or other qualified health professional may review the patient’s health problems, medications, functional needs, and supports, then establish an individualized plan for ongoing care. The work goes beyond the assessment and planning ordinarily included in the associated evaluation and management service.
Report G0506 as an add-on with the primary E/M procedure; it is not a stand-alone service. The record should show the chronic care needs assessed, the planning performed, and how that work exceeded the routine E/M. CMS pays the add-on within the primary procedure’s global period. G0506 describes the comprehensive planning work, not the recurring monthly management service; report a monthly CCM code only when its own requirements are met.
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.
G0506 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $64.14 | $37.77 |
How the G0506 rate is calculated
Each of G0506’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 · G0506
RVUs × geographic indexes × conversion factor
Work0.87
0.87 RVUs× 1.000 GPCI
Practice expense1.06
1.06 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
1.9900
Conversion factor
$33.4009
Medicare rate
$66.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0506
The CMS indicators that decide how G0506 is paid alongside other services.
CMS payment indicators · G0506
CCM care planning
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
G0506 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99490Chronic care management
- 99490 represents recurring monthly CCM work. G0506 is for extensive assessment and care planning associated with a primary E/M service.
- 99487Complex chronic care management
- 99487 describes monthly complex CCM management. G0506 describes comprehensive assessment and care planning, rather than the recurring monthly management service.
- 99491Chronic care management
- 99491 represents monthly CCM personally furnished by a physician or qualified health professional. G0506 is an add-on for comprehensive care planning with a primary E/M service.
G0506 billing questions
When should G0506 be chosen instead of reporting only the E/M service?
Use it when the physician or qualified health professional performs extensive chronic care assessment and planning beyond the work ordinarily included in the E/M service. Routine discussion of chronic conditions during an office visit alone does not establish that additional work.
What primary service must accompany G0506?
G0506 is an add-on and must be reported with a primary E/M procedure. CMS pays it within that primary procedure’s global period.
Does G0506 represent the monthly CCM service?
No. It represents comprehensive assessment and care planning, not recurring monthly management. A monthly CCM code requires its own qualifying work and documentation.
What documentation supports G0506?
Document the chronic care needs assessed, the individualized planning performed, and why that work went beyond the associated E/M service. A care plan should reflect the patient’s conditions and care needs rather than a routine problem list alone.
Can G0506 be reported with an office E/M code?
Yes, it is reported as an add-on to a qualifying primary E/M service. Examples include office E/M codes 99214 and 99215; the record must support the additional comprehensive planning work.
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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