How much does Medicare pay for HCPCS G2214?

Medicare allowed an average of $52.38 per service and paid $41.51 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $150.65, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does G2214 pay differently in an office than a hospital?

Yes. The allowed amount averaged $53.61 in an office setting and $31.77 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 G2214 most?

Nurse Practitioner, with 9,150 services from 67 clinicians. Next are Physician Assistant, Emergency Medicine, Family Practice.

HCPCS G2214

Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care

$52.38Medicare-allowed amount per service, averaged across 22,129 services

Providers submitted

$150.65

Asking price, not received

Medicare allowed

$52.38

The fee schedule figure

Medicare paid

$41.51

Balance is patient coinsurance

Providers submitted an average of $150.65 for this code and Medicare allowed $52.38 — 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 $41.51 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $53.61
Hospital / facility: $31.77

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. 20,878 services were billed in an office setting and 1,251 in a facility.

Services: 22,129
Beneficiaries: 16,562
Providers billing it: 120
Total allowed: $1,159,117

What Medicare pays for HCPCS G2214

Across 22,129 services billed by 120 providers to 16,562 beneficiaries, Medicare allowed an average of $52.38 per service. That is 1.3 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 G2214

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	9,150	5,696	$46.40	67
Physician Assistant	5,655	5,066	$48.92	25
Emergency Medicine	3,635	3,634	$70.00	1
Family Practice	1,906	989	$53.38	10
Internal Medicine	870	680	$56.89	13
Physical Medicine and Rehabilitation	429	54	$62.43	1
Cardiology	386	380	$55.85	1
Licensed Clinical Social Worker	68	33	$31.86	1
General Practice	30	30	$56.69	1

G2214 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
New York	5,963	$50.77	$39.03	14
Indiana	3,669	$69.77	$44.83	2
Texas	3,159	$41.86	$34.35	12
Florida	2,865	$49.26	$38.69	32
Minnesota	815	$51.15	$39.68	21
Pennsylvania	746	$49.85	$38.14	1
Louisiana	660	$52.70	$43.20	1
California	624	$59.35	$42.43	6
Georgia	596	$49.16	$38.06	2
Michigan	569	$45.90	$36.29	12
Rhode Island	558	$50.17	$38.14	1
Idaho	525	$49.32	$40.40	1
Illinois	262	$46.66	$37.62	1
Arizona	251	$47.55	$38.01	2
Maryland	221	$54.44	$39.26	3
Virginia	186	$46.94	$38.04	1
Kansas	159	$42.23	$34.19	1
New Jersey	143	$51.36	$36.39	1
Wisconsin	73	$45.71	$38.02	3
North Carolina	38	$53.61	$44.88	1
Connecticut	34	$60.90	$41.63	1
Oklahoma	13	$44.90	$38.15	1

Related codes

G2211Visit complexity inherent to evaluation and management associated$15.87
G2212Prolonged office or other outpatient evaluation and management service$31.02
G2252Brief communication technology-based service$25.76

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.