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See a sample rate comparisonHCPCS G2005 Fee Schedule
Medicare rates as of October 2026
HCPCS G2005 is classified under Procedures / Professional Services, in the Other Evaluation and Management Services subgroup.
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.)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Evaluation and Management Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $217.11 national non-facility rate (2026) · View Medicare rates for G2005 |
| Medicaid Fee Schedule | $202.445 median of the 2 states in the free preview · View Medicaid rates for G2005 |
National average reimbursement for HCPCS G2005 by major payers:
$283.51
BCBS / Anthem
$277.11
UnitedHealthcare
$205.64
Aetna
$222.31
Cigna
Compare published rates across providers.
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HCPCS G2005
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$538.89Published rateGrady Memorial Hospital Corporation, Grady Health Systems
Emory University
$369.54Published rateLower Oconee Community Hospital Inc
$272.82Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$247.50Published rateCindy Chang
Miguel A Arenas Md PC
$175.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G2005 vs. Other Other Evaluation and Management Services Codes
The table lists codes related to G2005. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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.) |
| G2006-HCPCS | Low | Brief (20 minutes) in-home visit for an existing 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 G2005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G2005 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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