Non-Facility
Private Office Rate
$111.56
Effective Q3 2026
Physician Service
G9980 Medicare Reimbursement Rate (2026)
Current CMS pricing and breakdown for Remote e/m new pt 30 mins.
CPT Code G9980
National Average Payment
Facility
Hospital / Outpatient Facility Rate
$65.47
Effective Q3 2026
National Medicare payment
The amounts shown are the published national payments. Local payment can vary based on your specific Zip Code, GPCI adjustments, and site of service.
Rates vary by location
Your actual reimbursement depends on your specific Zip Code and GPCI adjustments (e.g., New York vs. Texas).
Historical Medicare Reimbursement
| Quarter | Non-Facility Rate | Facility Rate | YoY % Change (Non-Fac) | YoY % Change (Fac) |
|---|---|---|---|---|
| 2026 Q3 | $111.56 | $65.47 | +8.11% | -10.84% |
| 2026 Q2 | $111.56 | $65.47 | +8.11% | -10.84% |
| 2026 Q1 | $111.56 | $65.47 | +8.11% | -10.84% |
| 2025 Q4 | $103.19 | $73.43 | — | — |
| 2025 Q3 | $103.19 | $73.43 | — | — |
| 2025 Q2 | $103.19 | $73.43 | — | — |
| 2025 Q1 | $103.19 | $73.43 | — | — |
Code Description
Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed 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 moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Reimbursement Summary
CPT code G9980 (Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed 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 moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology) had a 2026 Medicare non-facility reimbursement rate of $111.56. This reflects a 8.11% change from the prior year. The code carries 3.34 total RVUs across work, practice expense, and malpractice components.
For 2026, the estimated National Average Medicare payment for G9980 is $111.56 in a non-facility (office) setting and $65.47 in a facility (hospital/outpatient) setting. Your actual reimbursement depends on locality adjustments.
This code’s RVU components (Work, Practice Expense, and Malpractice) combine to approximately 3.34 total RVUs in the office setting and 1.96 total RVUs in the facility setting.
Description: Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci.... For locality-adjusted estimates, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool.
Note: amounts shown are estimates based on CMS national averages for Q3 2026.
Q3 2026 Breakdown
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | 1.42 | 1.42 |
| Practice Expense (PE) | 1.76 | 0.38 |
| Malpractice (MP) | 0.16 | 0.16 |
| Total RVUs | 3.34 | 1.96 |
Are you being paid correctly for this code?
Compare a payment against the Medicare benchmark for this code.
Medicare rates are used as a benchmark only. Actual payer contracts, modifiers, place of service, units, and billing rules may affect reimbursement. This tool is for educational and operational review purposes, not legal or billing advice.
Facility vs. Non-Facility (Office) Payment
Medicare often publishes two payment rates for the same code: a **non-facility** rate (typically used when the service is performed in a private office where the clinician bears more overhead) and a **facility** rate (typically used when performed in a hospital or facility where the facility bills separately for its costs).
Because the practice expense portion of RVUs differs by setting, the non-facility and facility payment amounts can be different. For locality-adjusted estimates in 2026, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool.
Learn How This Reimbursement Is Calculated
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
Frequently Asked Questions
What is the 2026 Medicare rate for G9980?
The 2026 National Average Medicare reimbursement rate for G9980 (Physician Service) is $111.56. This rate is effective as of January 1, 2026.
What is the description for code G9980?
Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed 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 moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Why do facility and non-facility payments differ for G9980?
For many physician services, Medicare publishes different practice-expense RVUs by setting. In general, non-facility rates apply when services are performed in a private office, while facility rates apply when performed in a hospital or facility where the facility bills separately.
How can I find my local Medicare rate for G9980?
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Is G9980 covered by Medicare?
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.
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99212 · established patient office visit, straightforward99213 · established patient office visit, low complexity99214 · established patient office visit, higher-complexity office visit99215 · established patient office visit, high complexity99202 · new patient office visit, straightforward99203 · new patient office visit, low complexity99204 · new patient office visit, moderate complexity99205 · new patient office visit, high complexityG9978 · nearby code in the same numeric familyG9979 · nearby code in the same numeric family
