G2003 Post-d/c h vst new pt 45 m
What G2003 is
Moderate (45 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.)
HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.
Medicare payment for G2003 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.53 | 0.95 | 0.12 | 3.60 | $120.24 |
| Facility (hospital, ASC) | 2.53 | 0.95 | 0.12 | 3.60 | $120.24 |
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 G2003 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.
Billed with G2003? These codes are bundled into it
G2003 is a Column 1 code in 12 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
G0076 | Care manag h vst new pt 20 m | 0 - no modifier bypass | Check pair |
G0077 | Care manag h vst new pt 30 m | 0 - no modifier bypass | Check pair |
G0078 | Care manag h vst new pt 45 m | 0 - no modifier bypass | Check pair |
G0079 | Care manag h vst new pt 60 m | 0 - no modifier bypass | Check pair |
G0080 | Care manag h vst new pt 75 m | 0 - no modifier bypass | Check pair |
G0081 | Care man h v ext pt 20 mi | 0 - no modifier bypass | Check pair |
G0082 | Care man h v ext pt 30 m | 0 - no modifier bypass | Check pair |
G0083 | Care man h v ext pt 45 m | 0 - no modifier bypass | Check pair |
G0084 | Care man h v ext pt 60 m | 0 - no modifier bypass | Check pair |
G0085 | Care man h v ext pt 75 m | 0 - no modifier bypass | Check pair |
G0086 | Care man home care plan 30 m | 0 - no modifier bypass | Check pair |
G0087 | Care man home care plan 60 m | 0 - no modifier bypass | 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.