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HCPCS G2013 Fee Schedule

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Extensive (75 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.)
Key FactDetail
Service Type

Procedures / Professional Services

Other Evaluation and Management Services

Complexity LevelModerate
Medicaid Fee ScheduleView Medicaid rates for G2013

National average reimbursement for HCPCS G2013 by major payers:

bcbs

$276.82

uhc

$277.11

aetna

$204.34

cigna

$222.30

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS G2013.

HCPCS G2013
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $538.89Published rate
  2. Emory Healthcare

    Emory University

    GAGeneral Acute Care HospitalNPI 1598964082Tax ID 58-2030692

    $434.76Published rate
  3. Julie Webster

    Carolina Radiology Associates, LLC

    SCBody Imaging PhysicianNPI 1396769964Tax ID 57-1049603

    $289.64Published rate
  4. Texas Radiology Associates LLP

    Texas Radiology Associates, LLP

    TXDiagnostic Radiology PhysicianNPI 1427016161Tax ID 75-1459885

    $247.50Published rate
  5. Alicia Encinas

    Miguel A Arenas Md PC

    CAFamily Nurse PractitionerNPI 1548859895Tax ID 30-0394179

    $181.83Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS G2013 vs. Other Other Evaluation and Management Services Codes

The HCPCS G2013 code is part of the Procedures / Professional Services services used for Other Evaluation and Management Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS G2013 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
G2013-HCPCSModerateExtensive (75 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.)
G2014-HCPCSLowLimited (30 minutes) 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 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 G2013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the G2013 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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