Medicare Reimbursement for G0077 – Care Management Home Visit, New Patient (30 min)
HCPCS code G0077 describes a care management home visit for a new patient lasting approximately 30 minutes. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code nationally and by locality, along with non-facility and facility rates.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $74.48 | $74.48 |
| ALASKA* (AK) | $100.21 | $100.21 |
| ALABAMA (AL) | $70.80 | $70.80 |
| ARKANSAS (AR) | $70.34 | $70.34 |
| ARIZONA (AZ) | $73.48 | $73.48 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $86.73 | $86.73 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $88.11 | $88.11 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $78.91 | $78.91 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $79.69 | $79.69 |
| NAPA (CA) | $83.33 | $83.33 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $86.81 | $86.81 |
| VALLEJO (CA) | $83.22 | $83.22 |
| BAKERSFIELD (CA) | $76.59 | $76.59 |
| CHICO (CA) | $76.31 | $76.31 |
| FRESNO (CA) | $76.31 | $76.31 |
| HANFORD-CORCORAN (CA) | $76.31 | $76.31 |
| MADERA (CA) | $76.31 | $76.31 |
| MERCED (CA) | $76.31 | $76.31 |
| MODESTO (CA) | $76.31 | $76.31 |
| REDDING (CA) | $76.31 | $76.31 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $77.11 | $77.11 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $78.71 | $78.71 |
| SALINAS (CA) | $78.37 | $78.37 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $88.43 | $88.43 |
| SANTA CRUZ-WATSONVILLE (CA) | $79.06 | $79.06 |
| SANTA ROSA-PETALUMA (CA) | $79.80 | $79.80 |
| STOCKTON (CA) | $76.31 | $76.31 |
| VISALIA (CA) | $76.31 | $76.31 |
| YUBA CITY (CA) | $76.31 | $76.31 |
| EL CENTRO (CA) | $76.33 | $76.33 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $79.13 | $79.13 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $77.23 | $77.23 |
| SANTA MARIA-SANTA BARBARA (CA) | $78.37 | $78.37 |
| REST OF CALIFORNIA (CA) | $76.31 | $76.31 |
| COLORADO (CO) | $75.95 | $75.95 |
| CONNECTICUT (CT) | $77.64 | $77.64 |
| DC + MD/VA SUBURBS (DC) | $81.29 | $81.29 |
| DELAWARE (DE) | $74.25 | $74.25 |
| FORT LAUDERDALE (FL) | $76.65 | $76.65 |
| MIAMI (FL) | $78.94 | $78.94 |
| REST OF FLORIDA (FL) | $74.72 | $74.72 |
| ATLANTA (GA) | $75.45 | $75.45 |
| REST OF GEORGIA (GA) | $72.62 | $72.62 |
| HAWAII, GUAM (HI) | $76.43 | $76.43 |
| IOWA (IA) | $71.26 | $71.26 |
| IDAHO (ID) | $71.54 | $71.54 |
| EAST ST. LOUIS (IL) | $75.14 | $75.14 |
| SUBURBAN CHICAGO (IL) | $77.22 | $77.22 |
| CHICAGO (IL) | $77.97 | $77.97 |
| REST OF ILLINOIS (IL) | $73.94 | $73.94 |
| INDIANA (IN) | $71.72 | $71.72 |
| KANSAS (KS) | $71.27 | $71.27 |
| KENTUCKY (KY) | $71.91 | $71.91 |
| NEW ORLEANS (LA) | $73.54 | $73.54 |
| REST OF LOUISIANA (LA) | $71.93 | $71.93 |
| METROPOLITAN BOSTON (MA) | $80.46 | $80.46 |
| REST OF MASSACHUSETTS (MA) | $75.95 | $75.95 |
| BALTIMORE/SURR. CNTYS (MD) | $77.41 | $77.41 |
| REST OF MARYLAND (MD) | $75.06 | $75.06 |
| SOUTHERN MAINE (ME) | $73.43 | $73.43 |
| REST OF MAINE (ME) | $71.89 | $71.89 |
| DETROIT (MI) | $75.34 | $75.34 |
| REST OF MICHIGAN (MI) | $72.93 | $72.93 |
| MINNESOTA (MN) | $73.46 | $73.46 |
| METROPOLITAN ST. LOUIS (MO) | $73.46 | $73.46 |
| METROPOLITAN KANSAS CITY (MO) | $73.13 | $73.13 |
| REST OF MISSOURI (MO) | $71.47 | $71.47 |
| MISSISSIPPI (MS) | $70.90 | $70.90 |
| MONTANA** (MT) | $74.48 | $74.48 |
| NORTH CAROLINA (NC) | $72.21 | $72.21 |
| NORTH DAKOTA** (ND) | $73.10 | $73.10 |
| NEBRASKA (NE) | $71.38 | $71.38 |
| NEW HAMPSHIRE (NH) | $75.07 | $75.07 |
| NORTHERN NJ (NJ) | $81.26 | $81.26 |
| REST OF NEW JERSEY (NJ) | $78.71 | $78.71 |
| NEW MEXICO (NM) | $73.18 | $73.18 |
| NEVADA** (NV) | $74.11 | $74.11 |
| MANHATTAN (NY) | $82.57 | $82.57 |
| NYC SUBURBS/LONG ISLAND (NY) | $83.78 | $83.78 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $79.29 | $79.29 |
| QUEENS (NY) | $82.66 | $82.66 |
| REST OF NEW YORK (NY) | $72.72 | $72.72 |
| OHIO (OH) | $72.64 | $72.64 |
| OKLAHOMA (OK) | $71.68 | $71.68 |
| PORTLAND (OR) | $77.07 | $77.07 |
| REST OF OREGON (OR) | $73.70 | $73.70 |
| METROPOLITAN PHILADELPHIA (PA) | $76.73 | $76.73 |
| REST OF PENNSYLVANIA (PA) | $72.60 | $72.60 |
| PUERTO RICO (PR) | $74.68 | $74.68 |
| RHODE ISLAND (RI) | $75.90 | $75.90 |
| SOUTH CAROLINA (SC) | $72.51 | $72.51 |
| SOUTH DAKOTA** (SD) | $72.93 | $72.93 |
| TENNESSEE (TN) | $71.46 | $71.46 |
| BRAZORIA (TX) | $74.18 | $74.18 |
| DALLAS (TX) | $74.52 | $74.52 |
| GALVESTON (TX) | $74.34 | $74.34 |
| HOUSTON (TX) | $75.62 | $75.62 |
| BEAUMONT (TX) | $72.39 | $72.39 |
| FORT WORTH (TX) | $74.34 | $74.34 |
| AUSTIN (TX) | $75.56 | $75.56 |
| REST OF TEXAS (TX) | $73.17 | $73.17 |
| UTAH (UT) | $72.96 | $72.96 |
| VIRGINIA (VA) | $73.43 | $73.43 |
| VIRGIN ISLANDS (VI) | $74.68 | $74.68 |
| VERMONT (VT) | $73.12 | $73.12 |
| SEATTLE (KING CNTY) (WA) | $81.45 | $81.45 |
| REST OF WASHINGTON (WA) | $75.72 | $75.72 |
| WISCONSIN (WI) | $71.97 | $71.97 |
| WEST VIRGINIA (WV) | $72.69 | $72.69 |
| WYOMING** (WY) | $73.88 | $73.88 |
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How the amount is calculated
Medicare's PFS payment is based on three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. These RVUs are adjusted using Geographic Practice Cost Indices (GPCIs) that reflect local cost differences, then the adjusted RVUs are multiplied by the annual conversion factor to produce a dollar amount. Non-facility and facility settings can have different practice-expense RVUs, which is why the allowed amount may differ depending on where the service is performed. For this code, the non-facility and facility PE RVUs are the same, so the national amounts shown do not differ by site of service.
RVUs — work 1.52, practice expense 0.64 (non-facility) / 0.64 (facility), malpractice 0.07 — × the locality GPCIs × the 2026 conversion factor of $33.40.
Good to know
- This is an estimate only; actual payment may vary by locality, contractor, and claim-specific factors.
- Medicare typically pays 80% of the allowed amount after the patient meets their deductible; the patient or secondary insurance is responsible for the remainder.
- Modifiers, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
- Always verify current rates with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.
Frequently asked
Does the payment amount differ between non-facility and facility settings for G0077?
Based on the RVUs shown, the non-facility and facility practice-expense RVUs are identical for this code, so the calculated national amounts are the same for both settings.
Why might my locality's payment differ from the national amount shown?
Local Geographic Practice Cost Indices (GPCIs) adjust the work, practice expense, and malpractice RVUs to reflect regional cost differences, which changes the final calculated amount for a given locality.
Can this amount change during the year?
Yes. CMS can apply budget-neutrality adjustments, sequestration, or other policy changes that affect the conversion factor or RVUs, which may alter the payment amount even within the same calendar year.
Is this the amount my practice will actually be paid?
No. This is an estimated allowed amount under the Medicare Physician Fee Schedule. Actual reimbursement depends on the patient's deductible status, applicable modifiers, and your MAC's specific processing rules.
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Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.
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