HCPCS G9985 Fee Schedule

Last Verified: December 2025

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.

Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) model episode of care, which requires at least 2 of the following 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. Counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology.

Key Fact	Detail
Service Type	• Procedures / Professional Services • Remote In-House Evaluation And Management Assessment
Complexity Level	Low

National average reimbursement for HCPCS G9985 by major payers:

$123.45

$100.49

$77.71

$121.65

Preview provider-level rates for...

For billing codeHCPCS G9985

Payer	Code	Rate	NPI	Tax ID	State	Specialty
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS G9985
United	G9985	$190.91	1073502985 - CHU CHEN	42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.	MA	Pediatrics Physician (208000000X)
United	G9985	$65.38	1225014657 - CAROLINA RADIOLOGY ASSOCIATES LLC	571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC	SC	Diagnostic Radiology Physician (2085R0202X)
United	G9985	$115.01	1225014657 - CAROLINA RADIOLOGY ASSOCIATES LLC	571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC	SC	Diagnostic Radiology Physician (2085R0202X)
United	G9985	$166.49	1033165865 - DAVID EPSTEIN	591212948 - (FL) RADIOLOGY ASSOCIATES OF CLEARWATER, P.A.	FL	Diagnostic Radiology Physician (2085R0202X)
United	G9985	$65.38	1225014657 - CAROLINA RADIOLOGY ASSOCIATES LLC	571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC	SC	Diagnostic Radiology Physician (2085R0202X)
United	G9985	$103.12	1396769964 - JULIE WEBSTER	571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC	SC	Body Imaging Physician (2085B0100X)
United	G9985	$92.29	1396769964 - JULIE WEBSTER	853861695 - MUSC COMMUNITY PHYSICIANS	SC	Body Imaging Physician (2085B0100X)
United	G9985	$103.12	1396769964 - JULIE WEBSTER	571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC	SC	Body Imaging Physician (2085B0100X)
United	G9985	$103.12	1396769964 - JULIE WEBSTER	571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC	SC	Body Imaging Physician (2085B0100X)
United	G9985	$109.44	1396769964 - JULIE WEBSTER	853861695 - MUSC COMMUNITY PHYSICIANS	SC	Body Imaging Physician (2085B0100X)
United	G9985	$65.38	1225014657 - CAROLINA RADIOLOGY ASSOCIATES LLC	571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC	SC	Diagnostic Radiology Physician (2085R0202X)
United	G9985	$115.01	1225014657 - CAROLINA RADIOLOGY ASSOCIATES LLC	571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC	SC	Diagnostic Radiology Physician (2085R0202X)
United	G9985	$92.29	1396769964 - JULIE WEBSTER	853861695 - MUSC COMMUNITY PHYSICIANS	SC	Body Imaging Physician (2085B0100X)
United	G9985	$92.29	1396769964 - JULIE WEBSTER	853861695 - MUSC COMMUNITY PHYSICIANS	SC	Body Imaging Physician (2085B0100X)
United	G9985	$109.44	1396769964 - JULIE WEBSTER	853861695 - MUSC COMMUNITY PHYSICIANS	SC	Body Imaging Physician (2085B0100X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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HCPCS G9985 vs. Other Remote In-House Evaluation And Management Assessment Codes

The HCPCS G9985 code is part of the Procedures / Professional Services services used for Remote In-House Evaluation And Management Assessment. 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 G9985 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.

Code	Complexity	Description
G9984-HCPCS	Low	Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) model episode of care, which requires at least 2 of the following 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity, furnished in real time using interactive audio and video technology. Counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology.
G9985-HCPCS	Low	Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) model episode of care, which requires at least 2 of the following 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. Counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology.
G9986-HCPCS	Low	Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) model episode of care, which requires at least 2 of the following 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity, furnished in real time using interactive audio and video technology. Counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9985. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the G9985 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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