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HCPCS G0180 Medicare Reimbursement & Commercial Rate Comparison

HCPCS G0180
- Physician or allowed practitioner certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care.
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Below, you'll find the 2025 Medicare reimbursement amount as published in the official CMS fee schedule nationally and by locality, along with a side-by-side comparison of national commercial rates from Aetna, Cigna, United Healthcare, and Blue Cross Blue Shield.

Medicare Reimbursement for HCPCS G0180

Non-facility rates apply in clinics or offices, where the provider covers all costs, so rates are typically higher.

Facility rates apply when services are done in hospitals or similar settings. Medicare covers overhead separately.

View reimbursement by different Medicare localities and years
Non-Facility Rate
$52.08
Non-Facility Rate
National
Facility Rate
$52.08
Facility Rate
National

Compare to National Avg. In-Network Commercial Rates

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bcbs

$70.24

uhc

$70.57

cigna

$58.49

aetna

$63.95

Find Medicare Reimbursement for Other Codes

Use our free lookup tool to explore Medicare and commercial reimbursement for any billing code. Type or select a code to view its details.

Related Codes

What is Medicare fee schedule?

The Medicare fee schedule is the list of payment amounts that Medicare uses to reimburse healthcare providers for services. It's updated annually and varies by geographic locality.

How are Medicare rates determined?

Medicare rates are calculated using the Resource-Based Relative Value Scale (RBRVS), which considers physician work, practice expenses, and malpractice costs, adjusted for geographic location.

Why do Medicare rates vary by location?

Medicare adjusts rates based on Geographic Practice Cost Indices (GPCIs) to account for differences in costs of living, wages, and practice expenses across different geographic areas.

What is Medicare Reimbursement?

Medicare fee schedules determine how much healthcare providers are paid for services.

These standardized rates help ensure consistent payment across the Medicare system while accounting for regional cost differences.

65M+

Medicare beneficiaries

across all 50 states

89

Medicare localities

with different rates

10,000+

Billable codes

in the fee schedule

All codes

CPT, HCPCS

and more…

PayerPrice helps you understand Medicare rates and compare them to commercial payer rates— so you can make informed contracting decisions.

Medicare Reimbursement by Locality

Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)

Select Year:

YearBilling CodeLocalityNon-Facility FeeFacility Fee
2025G01800000000 - National$52.08$52.08
2025G01800111205 - San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)$65.46$65.46
2025G01800111209 - San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)$66.16$66.16
2025G01800111251 - Napa$61.74$61.74
2025G01800111252 - San Francisco-Oakland-Berkeley (Marin Cnty)$65.50$65.50
2025G01800111253 - Vallejo$61.67$61.67
2025G01800111254 - Bakersfield$54.72$54.72
2025G01800111255 - Chico$54.52$54.52
2025G01800111256 - Fresno$54.52$54.52
2025G01800111257 - Hanford-Corcoran$54.52$54.52

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