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See a sample rate comparisonHCPCS G0078 Fee Schedule
Medicare rates as of October 2026
HCPCS G0078 is classified under Procedures / Professional Services, in the Home Care Management Services subgroup.
Moderate (45 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)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Home Care Management Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $120.24 national non-facility rate (2026) · View Medicare rates for G0078 |
| Medicaid Fee Schedule | $63.795 median of the 2 states in the free preview · View Medicaid rates for G0078 |
National average reimbursement for HCPCS G0078 by major payers:
$172.22
BCBS / Anthem
$162.58
UnitedHealthcare
$124.49
Aetna
$129.49
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0078.
HCPCS G0078
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$302.32Published rateBradley Smith
Emergeortho, P.A.
$220.75Published rateAtlanta Vamc
$172.42Published rateJulie Webster
Musc Community Physicians
$153.35Published rateGeorge Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$105.56Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0078 vs. Other Home Care Management Services Codes
The table lists codes related to G0078. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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) |
| G0078-HCPCS | Low | Moderate (45 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) |
| G0079-HCPCS | Moderate | Comprehensive (60 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 G0078. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0078 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.
FREE SAMPLE MARKET COMPARISON
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