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 G9986 Fee Schedule
Medicare rates as of October 2026
HCPCS G9986 is classified under Procedures / Professional Services, in the Remote In-House Evaluation And Management Assessment subgroup.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Remote In-House Evaluation And Management Assessment |
| Complexity Level | Low |
| Medicare Fee Schedule | $169.34 national non-facility rate (2026) · View Medicare rates for G9986 |
| Medicaid Fee Schedule | $99.645 median of the 2 states in the free preview · View Medicaid rates for G9986 |
National average reimbursement for HCPCS G9986 by major payers:
$170.36
BCBS / Anthem
$141.93
UnitedHealthcare
$111.27
Aetna
$167.72
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G9986.
HCPCS G9986
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$412.10Published rateJayne Bernier
Radiology Associates Of Clearwater, P.A.
$235.49Published rateRabia Jamy
Texas Neurology, P. A.
$132.66Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$124.33Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$96.62Published 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 G9986 vs. Other Remote In-House Evaluation And Management Assessment Codes
The table lists codes related to G9986. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| G9987-HCPCS | Low | Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a BPCI Advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9986. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9986 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 G9986) and we'll show you how you compare in 15 minutes or less.