G0080 Care manag h vst new pt 75 m
What G0080 is
Extensive (75 minutes) care management home visit for a new patient. 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)
HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.
Medicare payment for G0080 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 4.09 | 2.16 | 0.25 | 6.50 | $217.11 |
| Facility (hospital, ASC) | 4.09 | 2.16 | 0.25 | 6.50 | $217.11 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps G0080 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
G0080 is bundled into these codes
G0080 appears as a Column 2 code in 12 active edits. Reported with one of these Column 1 codes on the same date of service, G0080 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
G2001 | Post d/c h vst new pt 20 m | 0 | Check pair |
G2002 | Post-d/c h vst new pt 30 m | 0 | Check pair |
G2003 | Post-d/c h vst new pt 45 m | 0 | Check pair |
G2004 | Post-d/c h vst new pt 60 m | 0 | Check pair |
G2005 | Post-d/c h vst new pt 75 m | 0 | Check pair |
G2006 | Post-d/c h vst ext pt 20 m | 0 | Check pair |
G2007 | Post-d/c h vst ext pt 30 m | 0 | Check pair |
G2008 | Post-d/c h vst ext pt 45 m | 0 | Check pair |
G2009 | Post-d/c h vst ext pt 60 m | 0 | Check pair |
G2013 | Post-d/c h vst ext pt 75 m | 0 | Check pair |
G2014 | Post-d/c care plan overs 30m | 0 | Check pair |
G2015 | Post-d/c care plan overs 60m | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.