Medicare Reimbursement for G9984 – Remote E/M, Established Patient (15 Min)

HCPCS code G9984 describes a brief remote evaluation and management service for an established patient, typically about 15 minutes in duration. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for 2026, both at the national level and adjustable by locality, and separately for non-facility and facility 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: 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 fee for each code is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) that reflect local cost differences, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which is why the two allowed amounts are not the same. The national amounts shown use national GPCI values of 1.0, while locality-specific amounts apply the actual GPCIs for that area.

RVUs — work 0.97, practice expense 1.46 (non-facility) / 0.33 (facility), malpractice 0.09 — × 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 insurer is responsible for the remainder.
• Actual payment can vary by locality, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments to RVUs or the conversion factor.
• Always verify the current rate with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

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.