Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS G2004 Fee Schedule
Medicare rates as of October 2026
HCPCS G2004 is classified under Procedures / Professional Services, in the Other Evaluation and Management Services subgroup.
Comprehensive (60 minutes) in-home visit for a new patient post-discharge. 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 within 90 days following discharge from an inpatient facility and no more than 9 times.)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Evaluation and Management Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $163.66 national non-facility rate (2026) · View Medicare rates for G2004 |
| Medicaid Fee Schedule | $154.58 median of the 2 states in the free preview · View Medicaid rates for G2004 |
National average reimbursement for HCPCS G2004 by major payers:
$228.29
BCBS / Anthem
$226.97
UnitedHealthcare
$166.90
Aetna
$169.81
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G2004.
HCPCS G2004
5 of 25 sample ratesHigher to lower in this preview
Arthur M. Blank Hospital, Inc., Arthur M. Blank Hospital
Childrens Healthcare Of Atlanta Inc
$614.72Published rateEmory Crawford Long Hospital
Emory University
$282.33Published rateJenkins County Hospital LLC, Optim Medical Center - Jenkins
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$241.13Published rateJulie Webster
Musc Community Physicians
$214.44Published rateCindy Chang
Miguel A Arenas Md PC
$143.91Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS G2004 vs. Other Other Evaluation and Management Services Codes
The table lists codes related to G2004. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G2003-HCPCS | Low | Moderate (45 minutes) in-home visit for a new patient post-discharge. 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 within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2004-HCPCS | Moderate | Comprehensive (60 minutes) in-home visit for a new patient post-discharge. 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 within 90 days following discharge from an inpatient facility and no more than 9 times.) |
| G2005-HCPCS | Moderate | Extensive (75 minutes) in-home visit for a new patient post-discharge. 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 within 90 days following discharge from an inpatient facility and no more than 9 times.) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G2004. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G2004 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
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS G2004) and we'll show you how you compare in 15 minutes or less.