Medicare Reimbursement for G2083 (Esketamine Visit, >56 Minutes)

HCPCS code G2083 describes a monitored visit for administration of esketamine (e.g., Spravato) lasting longer than 56 minutes. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level and how it may vary by locality, distinguishing non-facility (e.g., office) and facility (e.g., hospital outpatient) settings.

Medicare allowed amount (2026)

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare PFS amounts are built from three Relative Value Units (RVUs): physician work, practice expense (PE), and malpractice (MP). Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality to reflect local cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar estimate. Non-facility and facility rates differ mainly because non-facility PE RVUs are higher — they include the practice's overhead for space, staff, and supplies used during the extended monitoring period, whereas in facility settings those overhead costs are borne by the facility itself.

RVUs — work 0.7, practice expense 39.83 (non-facility) / 0.16 (facility), malpractice 0.07 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

• This is an estimate only, not a guarantee of payment.
• Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the patient or secondary payer is generally responsible for the remainder.
• Actual payment can differ due to your specific locality, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments.
• Always verify final payment amounts and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

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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.