How much does Medicare pay for HCPCS G2252?

Medicare allowed an average of $25.76 per service and paid $19.61 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $63.34, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does G2252 pay differently in an office than a hospital?

Yes. The allowed amount averaged $25.88 in an office setting and $21.89 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 G2252 most?

Internal Medicine, with 1,445 services from 5 clinicians. Next are Rheumatology, Urology, Family Practice.

HCPCS G2252

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

$25.76Medicare-allowed amount per service, averaged across 2,691 services

Providers submitted

$63.34

Asking price, not received

Medicare allowed

$25.76

The fee schedule figure

Medicare paid

$19.61

Balance is patient coinsurance

Providers submitted an average of $63.34 for this code and Medicare allowed $25.76 — 2.5× 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 $19.61 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $25.88
Hospital / facility: $21.89

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. 2,606 services were billed in an office setting and 85 in a facility.

Services: 2,691
Beneficiaries: 994
Providers billing it: 21
Total allowed: $69,320

What Medicare pays for HCPCS G2252

Across 2,691 services billed by 21 providers to 994 beneficiaries, Medicare allowed an average of $25.76 per service. That is 2.7 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 G2252

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	1,445	245	$26.14	5
Rheumatology	936	493	$25.37	4
Urology	81	72	$28.97	2
Family Practice	59	49	$24.74	3
Nurse Practitioner	57	53	$20.51	2
Endocrinology	43	17	$24.59	1
Anesthesiology	22	20	$27.30	1
Hematology-Oncology	17	16	$24.69	1
Hospitalist	16	14	$26.63	1
Physician Assistant	15	15	$21.38	1

G2252 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
Illinois	955	$25.40	$20.51	5
Texas	948	$26.14	$20.15	3
Washington	478	$26.09	$18.43	1
California	88	$26.38	$20.08	3
New York	70	$29.64	$20.00	1
West Virginia	60	$22.65	$15.85	3
Oregon	28	$26.68	$17.57	2
Pennsylvania	25	$20.06	$14.48	1
Indiana	24	$19.78	$15.71	1
Kentucky	15	$21.38	$11.96	1

Related codes

G2211Visit complexity inherent to evaluation and management associated$15.87
G2212Prolonged office or other outpatient evaluation and management service$31.02
G2214Initial or subsequent psychiatric collaborative care management$52.38

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.