How much does Medicare pay for HCPCS G0446?

Medicare allowed an average of $24.56 per service and paid $24.56 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $51.50, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code G0446?

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. It was billed 355,929 times to 355,470 Medicare beneficiaries by 3,657 providers in 2024.

Does G0446 pay differently in an office than a hospital?

Yes. The allowed amount averaged $24.57 in an office setting and $21.20 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 G0446 most?

Internal Medicine, with 157,852 services from 1,317 clinicians. Next are Family Practice, Nurse Practitioner, Physician Assistant.

HCPCS G0446

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes

$24.56Medicare-allowed amount per service, averaged across 355,929 services

Providers submitted

$51.50

Asking price, not received

Medicare allowed

$24.56

The fee schedule figure

Medicare paid

$24.56

Balance is patient coinsurance

Providers submitted an average of $51.50 for this code and Medicare allowed $24.56 — 2.1× 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 $24.56 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $24.57
Hospital / facility: $21.20

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. 355,409 services were billed in an office setting and 520 in a facility.

Services: 355,929
Beneficiaries: 355,470
Providers billing it: 3,657
Total allowed: $8,741,616

What Medicare pays for HCPCS G0446

Across 355,929 services billed by 3,657 providers to 355,470 beneficiaries, Medicare allowed an average of $24.56 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 G0446

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	157,852	157,677	$25.42	1,317
Family Practice	136,082	135,850	$24.84	1,294
Nurse Practitioner	35,547	35,536	$20.63	677
Physician Assistant	13,941	13,933	$20.85	263
General Practice	5,098	5,098	$25.14	47
Cardiology	2,892	2,888	$27.99	10
Geriatric Medicine	1,657	1,657	$25.31	14
Endocrinology	711	706	$26.19	6
Emergency Medicine	698	676	$25.39	7
Nephrology	374	372	$28.10	2
Hospitalist	341	341	$25.72	5
Pediatric Medicine	260	260	$23.81	5
Obstetrics & Gynecology	206	206	$26.11	2
Certified Clinical Nurse Specialist	65	65	$21.28	1
Pulmonary Disease	49	49	$28.10	1

G0446 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	54,112	$24.69	$24.42	426
California	47,841	$26.57	$24.56	408
New York	27,583	$27.39	$24.33	373
Texas	25,004	$23.81	$24.25	300
South Carolina	24,260	$22.90	$23.77	170
Arizona	22,274	$22.48	$22.94	239
Georgia	18,025	$23.40	$24.28	177
North Carolina	15,639	$23.26	$24.20	205
New Jersey	15,065	$26.92	$24.61	125
Virginia	8,071	$24.66	$24.61	67
Alabama	7,664	$22.38	$23.99	101
Illinois	7,454	$25.48	$24.61	67
Tennessee	7,417	$22.05	$23.36	102
Maryland	7,028	$25.68	$24.02	66
Pennsylvania	6,765	$24.24	$24.48	76
Nevada	6,089	$24.28	$24.32	60
Washington	5,711	$24.00	$23.53	86
Colorado	5,475	$24.63	$24.43	52
Ohio	5,158	$23.89	$24.46	83
Mississippi	5,156	$21.47	$22.92	48
Massachusetts	4,929	$24.87	$24.35	57
Michigan	3,728	$24.82	$24.60	51
Missouri	3,298	$23.54	$24.57	39
Oklahoma	2,707	$22.61	$23.87	36
Louisiana	2,200	$23.43	$24.40	27
Rhode Island	1,877	$24.20	$23.74	25
Connecticut	1,616	$26.77	$24.46	21
Indiana	1,559	$23.44	$24.24	19
Kentucky	1,496	$22.87	$23.61	20
Kansas	1,489	$23.42	$24.65	10
Arkansas	1,212	$21.84	$22.96	17
West Virginia	1,175	$22.44	$23.47	19
Delaware	1,080	$24.63	$24.63	7
Iowa	858	$22.99	$24.48	6
Oregon	806	$24.75	$24.58	13
Nebraska	778	$21.90	$22.87	7
Idaho	685	$23.57	$23.81	9
Montana	584	$22.03	$21.56	7
Utah	573	$23.92	$24.12	10
Wisconsin	494	$24.24	$24.63	8
New Mexico	336	$23.33	$23.64	4
Alaska	188	$27.72	$24.70	4
Hawaii	156	$22.78	$24.20	2
New Hampshire	115	$25.02	$24.61	2
District of Columbia	97	$27.40	$24.66	2
Maine	85	$24.27	$24.70	3
North Dakota	17	$24.11	$24.39	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
G0447Face-to-face behavioral counseling for obesity$24.83
G0402Initial preventive physical examination; face-to-face visit$158.02

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.