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See a sample rate comparisonHCPCS G0086 Fee Schedule
Medicare rates as of October 2026
HCPCS G0086 is classified under Procedures / Professional Services, in the Home Care Management Services subgroup.
Limited (30 minutes) care management home care plan oversight. 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 | $73.82 national non-facility rate (2026) · View Medicare rates for G0086 |
| Medicaid Fee Schedule | $39.615 median of the 2 states in the free preview · View Medicaid rates for G0086 |
National average reimbursement for HCPCS G0086 by major payers:
$106.02
BCBS / Anthem
$96.64
UnitedHealthcare
$75.26
Aetna
$79.30
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0086.
HCPCS G0086
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$190.50Published rateEmory Crawford Long Hospital
Emory University
$187.05Published rateJulie Webster
Musc Community Physicians
$98.50Published rateScreven County Hospital, LLC, Optim Medical Center - Screven
$89.63Published rateCindy Chang
Miguel A Arenas Md PC
$60.75Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0086 vs. Other Home Care Management Services Codes
The table lists codes related to G0086. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G0085-HCPCS | Moderate | Extensive (75 minutes) care management home visit for an existing 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) |
| G0086-HCPCS | Low | Limited (30 minutes) care management home care plan oversight. 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) |
| G0087-HCPCS | Low | Comprehensive (60 minutes) care management home care plan oversight. 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 G0086. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0086 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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