HCPCS G0076 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Procedures / Professional Services • Home Care Management Services |
| Complexity Level | Low |
National average reimbursement for HCPCS G0076 by major payers:
$74.61
$69.10
$52.56
$53.22
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS G0076 | ||||||
United | G0076 | $116.23 | 1063466183 - JAYNE BERNIER | 591212948 - (FL) RADIOLOGY ASSOCIATES OF CLEARWATER, P.A. | FL | Diagnostic Radiology Physician (2085R0202X) |
United | G0076 | $116.23 | 1063466183 - JAYNE BERNIER | 591212948 - (FL) RADIOLOGY ASSOCIATES OF CLEARWATER, P.A. | FL | Diagnostic Radiology Physician (2085R0202X) |
United | G0076 | $116.23 | 1063466183 - JAYNE BERNIER | 591212948 - (FL) RADIOLOGY ASSOCIATES OF CLEARWATER, P.A. | NY | Diagnostic Radiology Physician (2085R0202X) |
United | G0076 | $116.23 | 1063466183 - JAYNE BERNIER | 591212948 - (FL) RADIOLOGY ASSOCIATES OF CLEARWATER, P.A. | NY | Diagnostic Radiology Physician (2085R0202X) |
United | G0076 | $65.02 | 1396769964 - JULIE WEBSTER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Body Imaging Physician (2085B0100X) |
United | G0076 | $72.05 | 1396769964 - JULIE WEBSTER | 571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC | SC | Body Imaging Physician (2085B0100X) |
United | G0076 | $72.05 | 1396769964 - JULIE WEBSTER | 571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC | SC | Body Imaging Physician (2085B0100X) |
United | G0076 | $72.05 | 1396769964 - JULIE WEBSTER | 571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC | SC | Body Imaging Physician (2085B0100X) |
United | G0076 | $65.34 | 1396769964 - JULIE WEBSTER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Body Imaging Physician (2085B0100X) |
United | G0076 | $65.02 | 1396769964 - JULIE WEBSTER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Body Imaging Physician (2085B0100X) |
United | G0076 | $80.36 | 1225014657 - CAROLINA RADIOLOGY ASSOCIATES LLC | 571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC | SC | Diagnostic Radiology Physician (2085R0202X) |
United | G0076 | $65.34 | 1396769964 - JULIE WEBSTER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Body Imaging Physician (2085B0100X) |
United | G0076 | $168.21 | 1033165865 - DAVID EPSTEIN | 462439952 - (FL) BREVARD PHYSICIAN ASSOCIATES, PLLC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | G0076 | $65.02 | 1396769964 - JULIE WEBSTER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Body Imaging Physician (2085B0100X) |
United | G0076 | $57.02 | 1548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC | 232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.C | PA | Clinical Pathology/Laboratory Medicine Physician (207ZP0105X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS G0076 vs. Other Home Care Management Services Codes
The HCPCS G0076 code is part of the Procedures / Professional Services services used for Home Care Management Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS G0076 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| G0071-HCPCS | Low | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
| G0076-HCPCS | Low | Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility) |
| G0077-HCPCS | Low | Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0076. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0076 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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