HCPCS G9187: Home visitMedicare rate & RVUs in Washington
G9187 identifies a home visit furnished in connection with a Bundled Payments for Care Improvement episode, rather than a standard home-residence E/M level.
Medicare pays $53.28–$61.23 for G9187 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 G9187 covers
G9187 identifies a home visit connected to a Bundled Payments for Care Improvement (BPCI) episode. A physician or other qualified health professional may furnish the visit in the beneficiary’s home as part of care during that episode, including home-based recovery or follow-up. The code is specific to the BPCI context; it is not an E/M level selected by the visit’s complexity or duration.
Report G9187 when the documented service is a BPCI-related home visit. The record should support the home setting, the clinician and date of service, the clinical purpose of the visit, and its connection to the BPCI episode. CMS’s physician fee schedule assigns work, practice-expense, and malpractice relative value units to the code. A standard home or residence E/M code describes a different reporting approach; do not use it to represent the BPCI-specific service merely because the encounter occurred at home.
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.
Where G9187 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $53.28 | Unavailable |
| Seattle (King Cnty) | $61.23 | Unavailable |
How the G9187 rate is calculated
Each of G9187’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 · G9187
RVUs × geographic indexes × conversion factor
Work0.18
0.18 RVUs× 1.000 GPCI
Practice expense1.32
1.32 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.5300
Conversion factor
$33.4009
Medicare rate
$51.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G9187
G9187 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 · G9187
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$51.10
Higher because the practice carries its own overhead.
G9187 compared with similar codes
Compare codes · National
G9187 vs 99347 vs 99349: Medicare rates
How to choose
- 99347Home visit
- 99347 is a standard home or residence E/M code. G9187 identifies a home visit connected to a BPCI episode rather than an E/M level.
- 99349Home visit
- 99349 is selected under standard home or residence E/M criteria. Use G9187 for the BPCI-specific home-visit service, not as a substitute based only on visit complexity.
G9187 billing questions
Is G9187 a standard home or residence E/M code?
No. It identifies a home visit connected to a BPCI episode, rather than an E/M level based on patient status, medical decision making, or time.
How is G9187 distinguished from codes such as 99347 or 99349?
G9187 is BPCI-specific. Codes 99347 and 99349 are standard home or residence E/M codes selected under their own reporting criteria.
What documentation supports G9187?
Document the home setting, the service performed, the clinician and date, and the relationship of the visit to the BPCI episode.
Should G9187 be selected by time or E/M complexity?
No. The distinguishing factor is the BPCI connection, not an E/M time or complexity level.
Can G9187 and a home E/M code represent the same visit?
Do not report two codes as though they represent separate services when the record describes only one visit. A separately documented service requires its own coding support and applicable program guidance.
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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