Key facts for G2006
- Medicare payment
- $49.43
- PFS non-facility, national
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- Practitioner MUE
- 1
- MAI 3
- NCCI PTP pairs
- 12
- 12 hospital outpatient
- LCDs and articles
- 0 / 0
TL;DR
HCPCS Level II G2006 reads "Brief (20 minutes) in-home visit for an existing 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.)" in the October 2026 file; it dates from 2019. Under the 2026 physician fee schedule (October release) G2006 carries 1.00 work, 0.44 practice-expense and 0.04 malpractice RVUs, which at $33.4009 per RVU pays $49.43 non-facility and no facility amount facility before the locality adjustment. Qualifying APM participants get $49.68 at $33.5675. Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure). In the NCCI PTP files v323r0 G2006 appears in 0 practitioner pairs as column 2 and 12 as column 1, and in 0 hospital outpatient pairs as column 2 and 12 as column 1. G2006 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code C (carrier judgment, so the Medicare contractor decides coverage) and any NCD. OPPS status indicator B: Non-allowed item or service for OPPS. HCPCS record: BETOS M4A (home visit); pricing indicator 13; type of service 1 (medical care). 3 other active codes open with "Brief"; related codes: G2001, G0081, G0076, G2005.
G2006 descriptor and code status
The October 2026 HCPCS Level II file describes G2006 as “Brief (20 minutes) in-home visit for an existing 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.)”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.
| Field | Value |
|---|---|
| Short descriptor | Post-d/c h vst ext pt 20 m |
| Added to HCPCS | 2019-01-01 |
| Last action | N (no maintenance), effective 2019-01-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 13: physician fee schedule, priced by the contractor |
| BETOS category | M4A: home visit |
| Type of service | 1: medical care |
Medicare payment for G2006
Under the 2026 physician fee schedule (October release) G2006 carries 1.00 work, 0.44 practice-expense and 0.04 malpractice RVUs, which at $33.4009 per RVU pays $49.43 non-facility and no facility amount facility before the locality adjustment. Qualifying APM participants get $49.68 at $33.5675. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.
Physician fee schedule (RVU26D)
Status A: active: paid separately under the physician fee schedule when covered. Global period XXX (global surgery concept does not apply); PC/TC indicator 0 (physician service; the professional/technical split does not apply).
| Component | Non-facility | Facility |
|---|---|---|
| Work RVU | 1.00 | 1.00 |
| Practice expense RVU | 0.44 | NA |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVUs | 1.48 | NA |
| National payment (CF $33.4009) | $49.43 | n/a |
| Qualifying APM participant (CF $33.5675) | $49.68 | n/a |
- Multiple procedures (modifier 51): no multiple-procedure reduction
- Bilateral (modifier 50): 150% bilateral adjustment does not apply
- Assistant at surgery: assistant at surgery paid only with documentation; co-surgeons: co-surgeons not permitted; team surgery: team surgeons not permitted
- Physician supervision of diagnostic procedures: supervision concept does not apply
Hospital outpatient (OPPS Addendum B)
Status indicator B (Non-allowed item or service for OPPS), with no separate OPPS payment rate.
Medically Unlikely Edits for G2006
Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 1 | 3 Date of Service Edit: Clinical | Nature of Service/Procedure |
| Facility outpatient hospital | 1 | 3 Date of Service Edit: Clinical | Nature of Service/Procedure |
The MUE lookup for G2006 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
In the practitioner PTP file v323r0, G2006 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 12 (0% modifier-allowed); 0 earlier pairs have been deleted.
| Column-2 code | Pairs |
|---|---|
| G0076 Care manag h vst new pt 20 m | 1 |
| G0077 Care manag h vst new pt 30 m | 1 |
| G0078 Care manag h vst new pt 45 m | 1 |
| G0079 Care manag h vst new pt 60 m | 1 |
| G0080 Care manag h vst new pt 75 m | 1 |
| G0081 Care man h v ext pt 20 mi | 1 |
| G0082 Care man h v ext pt 30 m | 1 |
| G0083 Care man h v ext pt 45 m | 1 |
In the hospital outpatient PTP file v323r0, G2006 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 12 (0% modifier-allowed); 0 earlier pairs have been deleted.
| Column-2 code | Pairs |
|---|---|
| G0076 Care manag h vst new pt 20 m | 1 |
| G0077 Care manag h vst new pt 30 m | 1 |
| G0078 Care manag h vst new pt 45 m | 1 |
| G0079 Care manag h vst new pt 60 m | 1 |
| G0080 Care manag h vst new pt 75 m | 1 |
| G0081 Care man h v ext pt 20 mi | 1 |
| G0082 Care man h v ext pt 30 m | 1 |
| G0083 Care man h v ext pt 45 m | 1 |
G2006 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.
Pair counts show exposure, not the answer for one claim. Check G2006 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for G2006
No current LCD or billing and coding article lists G2006. The HCPCS coverage code C means carrier judgment, so the Medicare contractor decides coverage, and any National Coverage Determination for the service still applies.
Denials to expect on G2006
the modifier reported is inconsistent with the code
the claim lacks the description, invoice or pricing detail a contractor-priced code needs
Where QuickIntell fits for G2006 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G2006 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS G2006
What does HCPCS code G2006 describe?
"Brief (20 minutes) in-home visit for an existing 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.)" (short descriptor "Post-d/c h vst ext pt 20 m"), in the G section (procedures and professional services, temporary). Added 2019-01-01.
Is G2006 a CPT code?
No. G2006 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.
What does Medicare pay for G2006?
Under the 2026 physician fee schedule (October release) G2006 carries 1.00 work, 0.44 practice-expense and 0.04 malpractice RVUs, which at $33.4009 per RVU pays $49.43 non-facility and no facility amount facility before the locality adjustment. Qualifying APM participants get $49.68 at $33.5675.
How many units of G2006 can be billed per day?
Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure). For the practitioner MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover G2006?
G2006 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code C (carrier judgment, so the Medicare contractor decides coverage) and any NCD.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- NCCI PTP edits, hospital outpatient, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccioph-v323r0-f1.txtSHA-256 063f41b91ef9faa2…
Disclaimer
This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.