$116.14
G2003 is the 45-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.
On this page
CMS RVU26D · Effective 2026-10-01
G2004 Home visit Medicare reimbursement rates in Wisconsin
Reports a 60-minute post-discharge home evaluation and management visit for a beneficiary who qualifies as a new patient. Compare G2004 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 G2004 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
$158.06
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Home-based evaluation and management
About G2004: Post-discharge home visit, new patient, 60 minutes
Reports a 60-minute post-discharge home evaluation and management visit for a beneficiary who qualifies as a new patient.
G2004 describes a home visit after a beneficiary’s discharge, with the service documented at the 60-minute level for a new patient. A physician or other qualified health care professional assesses the beneficiary in the residence, such as during recovery after a hospital stay. The encounter may address current symptoms, medication use, mobility, support at home, and the need for further care.
Choose the new-patient series when the beneficiary meets the applicable new-patient definition; use the established-patient series otherwise. Document the discharge context, home setting, new-patient status, time supporting the selected level, clinical assessment, and plan. CMS assigns the code work, practice-expense, and malpractice relative value units under the Physician Fee Schedule. G2003 and G2005 are the neighboring new-patient levels for 45 and 75 minutes, respectively.
Where the value comes from
- Work RVU3.38 · 69%
- Practice expense (office) RVU1.36 · 28%
- Malpractice RVU0.16 · 3%
12
Medicare services in 2024 · #6155 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.
G2004 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$208.30
G2005 is the 75-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.
$174.10
G2009 is for an established patient at the 60-minute level. G2004 is the corresponding new-patient level.
Compare G2004 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
$158.06
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 G2004 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
15,412
- Code
- G2004
- Physician work
- 3.38
- Practice expense
- 1.36
- Malpractice
- 0.16
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.38 | × 1.000 | 3.3800 |
| Practice expense | 1.36 | × 0.958 | 1.3029 |
| Malpractice | 0.16 | × 0.308 | 0.0493 |
| Total RVUs | 4.7322 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$158.06
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.38 | 1 |
| Practice expense | 1.36 | 0.958 |
| Malpractice | 0.16 | 0.308 |
(3.38 × 1 + 1.36 × 0.958 + 0.16 × 0.308) × $33.4009 = $158.06
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.
G2004 billing questions
When should G2004 be selected instead of G2009?
Use G2004 for a qualifying new patient and G2009 for an established patient when the post-discharge home visit is documented at the 60-minute level.
How does G2004 differ from G2003 and G2005?
Those codes are the neighboring new-patient post-discharge home-visit levels: G2003 is 45 minutes and G2005 is 75 minutes. Select the level supported by the documented service time.
What documentation supports G2004?
Record that the visit occurred at the beneficiary’s home after discharge, the beneficiary’s new-patient status, the time supporting the 60-minute level, and the assessment and plan.
Can G2004 be reported for a clinic follow-up?
No. G2004 identifies a post-discharge home visit; a clinic encounter is not the home service represented by this code.
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.
15,409G2001,,Post d/c 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
15,410G2002,,Post-d/c 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
15,411G2003,,Post-d/c 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
15,412G2004,,Post-d/c 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
15,413G2005,,Post-d/c 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
15,414G2006,,Post-d/c h vst ext pt 20 m,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
15,415G2007,,Post-d/c h vst ext pt 30 m,A,,1.56,0.79,,0.79,NA,0.07,2.42,2.42,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,