How much does Medicare pay for HCPCS G2012?

Medicare allowed an average of $13.77 per service and paid $10.12 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $39.50, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does G2012 pay differently in an office than a hospital?

Yes. The allowed amount averaged $13.93 in an office setting and $11.57 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 G2012 most?

Family Practice, with 16,076 services from 86 clinicians. Next are Internal Medicine, Cardiology, Nurse Practitioner.

HCPCS G2012

Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic

$13.77Medicare-allowed amount per service, averaged across 54,676 services

Providers submitted

$39.50

Asking price, not received

Medicare allowed

$13.77

The fee schedule figure

Medicare paid

$10.12

Balance is patient coinsurance

Providers submitted an average of $39.50 for this code and Medicare allowed $13.77 — 2.9× 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 $10.12 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $13.93
Hospital / facility: $11.57

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. 50,954 services were billed in an office setting and 3,722 in a facility.

Services: 54,676
Beneficiaries: 25,963
Providers billing it: 543
Total allowed: $752,889

What Medicare pays for HCPCS G2012

Across 54,676 services billed by 543 providers to 25,963 beneficiaries, Medicare allowed an average of $13.77 per service. That is 2.1 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 G2012

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	16,076	4,801	$13.69	86
Internal Medicine	14,382	7,195	$14.29	138
Cardiology	6,550	2,708	$13.72	25
Nurse Practitioner	4,126	3,336	$11.24	100
Neurology	2,187	1,365	$14.66	22
Clinical Cardiac Electrophysiology	1,655	925	$13.99	5
Geriatric Medicine	1,124	415	$13.23	3
Nephrology	976	338	$13.45	4
Psychiatry	973	513	$15.24	11
Gastroenterology	840	545	$14.95	12
General Practice	677	229	$14.09	7
Physician Assistant	484	427	$11.61	19
Endocrinology	454	336	$15.10	13
Pathology	442	134	$15.32	1
Urology	380	272	$14.61	7

G2012 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
California	29,598	$13.93	$10.21	127
New York	3,929	$15.02	$9.73	64
Texas	2,925	$13.21	$9.21	43
Florida	2,280	$13.70	$9.86	33
Delaware	1,308	$13.66	$10.05	5
Arizona	1,156	$12.85	$9.57	10
Illinois	1,070	$12.87	$9.31	14
Washington	907	$13.78	$9.08	9
New Jersey	880	$14.46	$9.43	18
Nevada	853	$12.91	$9.56	9
Ohio	743	$12.16	$9.88	7
Pennsylvania	713	$12.88	$8.58	14
Alabama	644	$12.27	$8.71	9
Hawaii	637	$13.20	$9.18	11
Massachusetts	593	$14.03	$9.70	10
Michigan	573	$13.76	$10.07	7
Virginia	500	$13.21	$9.25	13
Maryland	493	$21.85	$9.35	12
South Carolina	476	$13.11	$8.85	8
Georgia	457	$12.90	$9.03	12
Tennessee	397	$11.33	$8.06	13
Mississippi	374	$10.42	$8.98	3
Indiana	301	$11.01	$8.28	8
Connecticut	287	$14.39	$9.89	7
Puerto Rico	282	$13.67	$9.74	6
Wisconsin	241	$12.07	$8.97	5
West Virginia	225	$12.03	$8.57	9
Oklahoma	220	$13.24	$10.73	2
Rhode Island	194	$12.95	$8.96	6
Kentucky	176	$11.69	$9.80	5
North Carolina	176	$13.12	$9.82	2
Minnesota	149	$13.04	$9.17	7
Oregon	140	$14.12	$9.59	8
Missouri	139	$13.07	$9.03	4
Maine	124	$11.07	$8.18	2
Louisiana	79	$12.37	$9.46	2
Kansas	61	$12.70	$9.27	2
U.S. Virgin Islands	54	$12.66	$8.51	2
Idaho	51	$10.04	$7.41	2
New Mexico	51	$12.83	$9.19	2
Wyoming	46	$13.89	$9.31	2
Arkansas	40	$10.82	$8.03	1
Utah	36	$12.21	$8.65	2
North Dakota	26	$11.42	$6.86	1
Vermont	24	$13.35	$10.04	1
Nebraska	13	$12.86	$10.14	1
Colorado	13	$13.72	$10.96	1
Montana	11	$11.77	$8.46	1
Alaska	11	$15.75	$10.93	1

Related codes

G2067Medication assisted treatment$225.81
G2078Take-home supply of methadone; up to 7 additional day supply (provisio$39.17
G2077Periodic assessment; assessing periodically by qualified personnel to$121.19
G2074Medication assisted treatment$204.11
G2083Office or other outpatient visit for the evaluation and management of$1215.85
G2011Alcohol and/or substance (other than tobacco) misuse structured assess$15.58
G2087Office-based treatment for opioid use disorder$367.01
G2068Medication assisted treatment$281.73
G2080Each additional 30 minutes of counseling in a week of medication assis$35.16
G2088Office-based treatment for opioid use disorder$49.83
G2076Intake activities$195.81
G2010Remote evaluation of recorded video and/or images submitted by an esta$11.93

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.