Medicare Reimbursement for G9982 – Remote E/M New Patient, 60 Minutes

HCPCS code G9982 describes a remote evaluation and management service for a new patient lasting 60 minutes. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount at the national level, distinguishing between non-facility and facility settings. Actual payment varies by locality and other adjustment factors.

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: Clinical. 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's PFS amount is built from three Relative Value Units (RVUs) — work, practice expense, and malpractice — assigned to each code. These RVUs are adjusted using Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, accounting for regional cost differences. The adjusted RVUs are summed and multiplied by the annual conversion factor (a dollar-per-RVU rate set by CMS) to produce the allowed amount. Non-facility and facility rates differ mainly in the practice-expense RVU, since non-facility settings (like a private office) assume the practice bears more overhead cost than a facility setting (like a hospital) where the facility itself absorbs certain costs.

RVUs — work 3.17, practice expense 3.23 (non-facility) / 0.94 (facility), malpractice 0.36 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

• This is an estimate only, based on national averages; actual payment depends on your specific Medicare Administrative Contractor (MAC) and locality GPCIs.
• Medicare typically pays 80% of the approved amount after the patient's deductible is met; the patient or secondary payer is responsible for the remainder.
• Modifiers, sequestration, and annual budget-neutrality adjustments can increase or decrease the final paid amount.
• Always verify current rates and coverage rules with your MAC before billing or appealing a denial.

Frequently asked

More free billing tools: all Medicare fees · fee calculator · denial code decoder

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.