$73.12
G0077 identifies a new-patient care-management home visit at the 30-minute level; G0078 identifies the 45-minute level.
On this page
CMS RVU26D · Effective 2026-10-01
G0078 Home care management Medicare reimbursement rates in Vermont
A 45-minute care-management home visit for a new patient, reported when the documented service matches the new-patient home-visit and time level. Compare G0078 office and facility rates across CMS payment localities in Vermont.
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 G0078 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$117.95
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
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.
Care management
About G0078: New-patient care-management home visit
A 45-minute care-management home visit for a new patient, reported when the documented service matches the new-patient home-visit and time level.
G0078 represents a care-management home visit for a new patient, with 45 minutes as its time designation. The service takes place in the patient’s home and focuses on care-management work during the visit. It is distinct from an office encounter and from other home-visit levels that specify a different patient category or duration.
Report G0078 when the record supports the new-patient category, home setting, care-management service, and 45-minute level. Documentation should identify the care needs addressed, the work performed during the visit, and the time supporting the selected level. CMS assigns relative value units for physician work, practice expense, and malpractice; the practice-expense valuation includes office and facility settings.
Where the value comes from
- Work RVU2.53 · 70%
- Practice expense (office) RVU0.95 · 26%
- Malpractice RVU0.12 · 3%
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.
G0078 compared with similar codes
Office rates for Vermont, from the same CMS release.
$160.57
Both are new-patient care-management home-visit levels. G0079 specifies 60 minutes rather than 45 minutes.
$125.50
G0083 is the 45-minute level for an established patient. G0078 is for a new patient.
$71.88
G0086 describes a care-management home-care-plan service with a 30-minute designation, rather than G0078’s new-patient home-visit level.
Compare G0078 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.
1 of 1 payment localities
Vermont →
Office / nonfacility
$117.95
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for G0078 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
15,070
- Code
- G0078
- Physician work
- 2.53
- Practice expense
- 0.95
- Malpractice
- 0.12
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.53 | × 1.000 | 2.5300 |
| Practice expense | 0.95 | × 0.990 | 0.9405 |
| Malpractice | 0.12 | × 0.506 | 0.0607 |
| Total RVUs | 3.5312 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$117.95
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.53 | 1 |
| Practice expense | 0.95 | 0.99 |
| Malpractice | 0.12 | 0.506 |
(2.53 × 1 + 0.95 × 0.99 + 0.12 × 0.506) × $33.4009 = $117.95
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
G0078 billing questions
How does G0078 differ from G0077?
Both describe new-patient care-management home visits, but G0077 is the 30-minute level and G0078 is the 45-minute level. Choose the level supported by the documented service time.
How does G0078 differ from G0083?
G0078 is for a new patient; G0083 is the 45-minute care-management home-visit level for an established patient.
What should the record show?
Document the home setting, the patient’s new-patient status, the care-management needs addressed, the work performed, and time supporting the 45-minute level.
Does G0078 describe an office visit?
No. Its descriptor identifies a care-management home visit. An office-based service does not match that setting.
Can G0078 be selected just because the appointment lasted 45 minutes?
The code also identifies a new-patient care-management home visit. The record should support the service type and patient category as well as the time 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 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.
15,067G0070,,Adm of chemo drug in home,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,068G0076,,Care manag h vst new pt 20 m,A,,1.01,0.43,,0.43,NA,0.04,1.48,1.48,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,069G0077,,Care manag h vst new pt 30 m,A,,1.52,0.64,,0.64,NA,0.07,2.23,2.23,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,070G0078,,Care manag h vst new pt 45 m,A,,2.53,0.95,,0.95,NA,0.12,3.60,3.60,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,071G0079,,Care manag h vst new pt 60 m,A,,3.38,1.36,,1.36,NA,0.16,4.90,4.90,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,072G0080,,Care manag h vst new pt 75 m,A,,4.09,2.16,,2.16,NA,0.25,6.50,6.50,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,073G0081,,Care man h v ext pt 20 mi,A,,1.00,0.44,,0.44,NA,0.04,1.48,1.48,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817