RxDoctor Payments Data

HCPCS G0136

Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes

$16.63Medicare-allowed amount per service, averaged across 160,637 services
Providers submitted
$33.92

Asking price, not received

Medicare allowed
$16.63

The fee schedule figure

Medicare paid
$12.81

Balance is patient coinsurance

Providers submitted an average of $33.92 for this code and Medicare allowed $16.632.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $12.81 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$16.97
Hospital / facility
$8.76

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 154,060 services were billed in an office setting and 6,577 in a facility.

Services
160,637

Medicare Part B, 2024

Beneficiaries
149,547
Providers billing it
2,431
Total allowed
$2,671,393

Services × allowed amount

What Medicare pays for HCPCS G0136

Across 160,637 services billed by 2,431 providers to 149,547 beneficiaries, Medicare allowed an average of $16.63 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills G0136

SpecialtyServicesBeneficiariesAvg allowedProviders
Family Practice63,24260,335$17.46867
Internal Medicine53,45350,697$18.16665
Nurse Practitioner26,80324,327$14.22571
Physician Assistant6,8106,098$11.79172
General Practice1,8821,525$13.8624
Hospitalist1,4411,097$9.5722
Hematology-Oncology1,4311,403$17.3229
Geriatric Medicine693680$17.1317
Certified Clinical Nurse Specialist64573$0.011
Cardiology602587$14.9813
Psychiatry552118$9.951
Nephrology394274$21.841
Emergency Medicine317316$19.766
Osteopathic Manipulative Medicine272267$14.342
Otolaryngology256163$0.011

G0136 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
North Carolina16,433$16.68$13.92182
Pennsylvania14,957$18.28$15.19224
New York12,928$19.51$12.97160
Maryland9,865$17.68$12.56130
Florida9,412$17.76$14.24164
New Jersey8,881$20.36$13.55123
Texas8,133$17.77$14.00147
Oklahoma7,972$1.42$1.3752
Michigan7,801$17.23$12.84133
California6,256$19.13$12.8976
Illinois6,168$17.84$13.2480
Colorado5,994$17.80$13.01108
Tennessee4,630$16.54$13.2182
Ohio4,361$16.84$13.7278
Nebraska4,103$9.50$7.2091
Indiana3,874$15.35$12.1966
Georgia3,466$15.49$14.5161
Delaware3,044$17.51$13.8857
Arkansas2,894$14.80$12.9529
South Carolina2,370$16.62$14.6335
Louisiana2,228$16.54$12.6528
Arizona2,146$17.96$13.4827
Virginia2,083$17.26$13.7835
Connecticut1,474$19.17$12.9336
Kentucky1,203$11.28$10.5235
Kansas1,076$13.27$11.0516
Wisconsin985$16.07$11.4829
Massachusetts931$19.58$13.4521
Minnesota914$16.27$12.9931
Alabama661$14.61$14.7820
Vermont592$18.32$14.347
Nevada536$14.42$13.277
New Hampshire337$16.96$11.879
District of Columbia336$20.99$14.435
West Virginia280$16.69$12.307
Rhode Island218$19.27$14.275
New Mexico212$17.44$13.233
Mississippi168$13.96$13.505
Idaho164$16.79$13.805
Hawaii156$20.71$14.864
Iowa113$16.24$13.235
Maine85$18.00$13.123
Washington62$19.07$13.861
South Dakota55$11.40$9.383
Oregon40$16.16$12.123
Utah27$20.13$14.362
Missouri13$17.36$14.871

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.