$32.31
Use G0318 for prolonged home or residence E/M time; G0317 is the prolonged-service code for nursing facility E/M.
On this page
CMS RVU26D · Effective 2026-10-01
G0318 Prolonged home visit Medicare reimbursement rates in Wisconsin
Reports each additional 15 minutes of prolonged physician or qualified professional time for eligible high-level home or residence evaluation and management services. Compare G0318 office and facility rates across CMS payment localities in Wisconsin.
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 G0318 in Wisconsin?
Wisconsin 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
$32.41
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$26.01
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
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.
Evaluation and management
About G0318: Prolonged home or residence E/M time
Reports each additional 15 minutes of prolonged physician or qualified professional time for eligible high-level home or residence evaluation and management services.
G0318 accounts for additional physician or qualified health care professional time spent on a prolonged evaluation and management service in a patient's home or residence. It is used with eligible high-level home or residence visits, such as a complex assessment in a private home or assisted living residence. The additional time may include work performed on the date of the visit with or without the patient present, consistent with the applicable E/M time rules.
Report G0318 only with an eligible primary home or residence E/M service, such as 99345 or 99350; it is not a standalone visit code. Select the primary service based on the applicable E/M criteria, and document total time and the work supporting the prolonged service. Each unit represents an additional 15 minutes. CMS classifies G0318 as an add-on code paid within the primary procedure's global period, so report it with that primary service rather than as a separate encounter.
CMS billing rules for G0318
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.61 · 60%
- Practice expense (office) RVU0.36 · 35%
- Malpractice RVU0.05 · 5%
155.1K
Medicare services in 2024 · #442 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.
G0318 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$33.05
G0318 applies to home or residence visits, while G0316 applies to prolonged inpatient or observation E/M services.
$32.41
G0318 is for eligible home or residence E/M services. G2212 is used for qualifying prolonged office or outpatient E/M services.
Compare G0318 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
Wisconsin →
Office / nonfacility
$32.41
Facility
$26.01
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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 G0318 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
15,195
- Code
- G0318
- Physician work
- 0.61
- Practice expense
- 0.36
- Malpractice
- 0.05
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.61 | × 1.000 | 0.6100 |
| Practice expense | 0.36 | × 0.958 | 0.3449 |
| Malpractice | 0.05 | × 0.308 | 0.0154 |
| Total RVUs | 0.9703 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$32.41
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.61 | 1 |
| Practice expense | 0.36 | 0.958 |
| Malpractice | 0.05 | 0.308 |
(0.61 × 1 + 0.36 × 0.958 + 0.05 × 0.308) × $33.4009 = $32.41
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.61 | 1 |
| Practice expense | 0.16 | 0.958 |
| Malpractice | 0.05 | 0.308 |
(0.61 × 1 + 0.16 × 0.958 + 0.05 × 0.308) × $33.4009 = $26.01
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.
G0318 billing questions
Which primary E/M codes can be paired with G0318?
G0318 is used with eligible high-level home or residence E/M services, including 99345 for a new patient and 99350 for an established patient.
Can G0318 be billed by itself?
No. CMS identifies it as an add-on code, so it must be reported with a qualifying primary home or residence E/M service.
How much time does one unit represent?
Each unit represents an additional 15 minutes of prolonged service time. Document the time and the work supporting the primary and prolonged services.
Can G0318 be used for a prolonged office visit?
No. G0318 is for prolonged home or residence E/M services. Prolonged office or outpatient E/M services use a different code pathway.
How does the global-period rule affect reporting?
CMS places payment for this add-on within the primary procedure's global period. Report G0318 with the primary home or residence E/M service, not as a separate encounter.
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.
15,192G0315,,Counsel immune <21 5-15 m,I,,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
15,193G0316,,Prolong inpt eval add15 m,A,,0.61,0.38,,0.17,,0.05,1.04,0.83,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,194G0317,,Prolong nursin fac eval 15m,A,,0.61,0.36,,0.16,,0.04,1.01,0.81,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,195G0318,,Prolong home eval add 15m,A,,0.61,0.36,,0.16,,0.05,1.02,0.82,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,196G0320,,Two-way audio and video hhs,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
15,197G0321,,Audio-only hhs,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
15,198G0322,,Home h physio data collec tr,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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,