How much does Medicare pay for HCPCS G0408?

Medicare allowed an average of $95.76 per service and paid $75.75 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $259.02, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does G0408 pay differently in an office than a hospital?

Yes. The allowed amount averaged $92.71 in an office setting and $101.62 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills G0408 most?

Nurse Practitioner, with 9,187 services from 64 clinicians. Next are Neurology, Infectious Disease, Internal Medicine.

HCPCS G0408

Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth

$95.76Medicare-allowed amount per service, averaged across 27,544 services

Providers submitted

$259.02

Asking price, not received

Medicare allowed

$95.76

The fee schedule figure

Medicare paid

$75.75

Balance is patient coinsurance

Providers submitted an average of $259.02 for this code and Medicare allowed $95.76 — 2.7× 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 $75.75 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $92.71
Hospital / facility: $101.62

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 18,125 services were billed in an office setting and 9,419 in a facility.

Services: 27,544
Beneficiaries: 14,523
Providers billing it: 290
Total allowed: $2,637,613

What Medicare pays for HCPCS G0408

Across 27,544 services billed by 290 providers to 14,523 beneficiaries, Medicare allowed an average of $95.76 per service. That is 1.9 services per beneficiary, so this is a code patients typically receive more than once. 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 G0408

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	9,187	4,015	$84.34	64
Neurology	8,372	5,302	$102.02	72
Infectious Disease	3,445	1,752	$102.30	39
Internal Medicine	2,585	1,200	$102.20	26
Psychiatry	1,108	771	$101.66	32
Nephrology	1,010	413	$100.37	14
Pulmonary Disease	744	417	$98.95	17
Physician Assistant	396	257	$85.24	6
Critical Care (Intensivists)	375	213	$103.88	10
Hospitalist	124	93	$103.50	5
Certified Clinical Nurse Specialist	75	19	$85.10	1
Gastroenterology	70	29	$98.16	1
Anesthesiology	22	14	$108.61	1
Cardiology	16	13	$100.84	1
Hematology-Oncology	15	15	$99.46	1

G0408 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.

State	Services	Allowed	Standardized pmt	Providers
Florida	7,257	$100.66	$79.19	44
Texas	4,370	$93.97	$75.48	51
Oklahoma	1,854	$85.84	$71.21	9
Louisiana	1,827	$90.54	$73.83	16
California	1,162	$103.56	$78.31	17
Tennessee	1,060	$86.18	$71.64	11
Michigan	893	$103.05	$78.14	8
Pennsylvania	819	$98.45	$79.49	11
Arizona	781	$100.63	$79.19	10
Mississippi	613	$83.08	$69.11	2
New York	514	$103.42	$75.53	9
New Mexico	479	$84.25	$69.75	3
Arkansas	465	$80.78	$68.42	6
Missouri	451	$91.73	$74.63	9
Kentucky	449	$93.71	$76.18	3
North Carolina	407	$92.75	$73.33	7
South Dakota	405	$96.25	$78.88	5
Illinois	341	$103.01	$80.14	8
Iowa	332	$85.08	$67.81	2
Georgia	327	$102.53	$81.20	2
Nebraska	280	$96.44	$81.29	7
Nevada	268	$96.03	$81.20	1
Ohio	266	$97.96	$80.20	8
Virginia	218	$90.24	$73.35	3
New Jersey	207	$104.13	$79.35	5
Washington	201	$104.25	$77.86	2
Vermont	182	$80.41	$68.88	1
Oregon	170	$109.02	$81.16	4
Indiana	156	$100.49	$81.10	4
Wisconsin	151	$93.41	$76.13	4
Idaho	129	$100.67	$80.82	2
Minnesota	113	$99.30	$80.06	4
Hawaii	95	$109.39	$81.29	1
Colorado	89	$104.62	$79.76	3
Massachusetts	56	$101.63	$77.82	3
Maryland	52	$107.20	$81.43	1
West Virginia	44	$94.91	$81.43	1
Connecticut	34	$113.89	$81.16	1
Montana	14	$97.86	$81.24	1
Alabama	13	$102.71	$81.12	1

Related codes

G0439Annual wellness visit$117.95
G0444Annual depression screening$17.80
G0471Collection of venous blood by venipuncture or urine sample by catheter$10.56
G0442Annual alcohol misuse screening$17.96
G0480Drug test(s), definitive, utilizing (1) drug identification methods ab$110.33
G0483Drug test(s), definitive, utilizing (1) drug identification methods ab$240.71
G0482Drug test(s), definitive, utilizing (1) drug identification methods ab$193.45
G0481Drug test(s), definitive, utilizing (1) drug identification methods ab$152.51
G0438Annual wellness visit; includes a personalized prevention plan of serv$151.05
G0453Continuous intraoperative neurophysiology monitoring$32.00
G0446Annual, face-to-face intensive behavioral therapy for cardiovascular d$24.56
G0447Face-to-face behavioral counseling for obesity$24.83

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.