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See a sample rate comparisonHCPCS G0426 Fee Schedule
Medicare rates as of October 2026
HCPCS G0426 is classified under Procedures / Professional Services, in the Initial Telehealth Consultations subgroup.
Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Initial Telehealth Consultations |
| Common Revenue Codes | 0960 |
| Medicare Fee Schedule | $117.24 national non-facility rate (2026)View Medicare rates for G0426 |
| Medicaid Fee Schedule | $103.385 median of the 8 states in the free previewView Medicaid rates for G0426 |
National average reimbursement for HCPCS G0426 by major payers:
$174.82
BCBS / Anthem
$173.03
UnitedHealthcare
$149.11
Aetna
$138.89
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0426.
HCPCS G0426
5 of 25 sample ratesHigher to lower in this preview
Jacob Holloway
$410.82Published rateMichael Guillette
Aztec Urgent Care LLC
$245.52Published rateThe Hospital Authority Of Monroe County, Georgia, Monroe County Hospital
The Hospital Authority Of Monroe County Georgia
$197.21Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$140.61Published rateMiguel Arenas
Miguel A Arenas Md PC
$111.06Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0426 vs. Other Initial Telehealth Consultations Codes
The table lists codes related to G0426. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0425-HCPCS | Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth |
| G0426-HCPCS | Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth |
| G0427-HCPCS | Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0426. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0426 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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Frequently Asked Questions
Which revenue codes are billed with HCPCS G0426?
Hospital price transparency files list HCPCS G0426 under these revenue codes: 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.