# HCPCS G0318: Prolonged home or residence evaluation and management service (add-on)

Medicare HCPCS G0318 pays $34.07 in a non-facility setting and $27.39 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $31.56 in Arkansas to $44.29 in Alaska, a 40% spread.

Web page: https://www.med-reveal.com/rates/G0318-hcpcs-fee-schedule
Section: Evaluation and Management

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $34.07 |
| National facility | $27.39 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $44.29 | $37.17 |
| District of Columbia | $37.50 | $29.63 |
| New York | $37.03 | $29.57 |
| New Jersey | $36.77 | $29.25 |
| California | $36.24 | $28.33 |
| Washington | $36.04 | $28.42 |
| Massachusetts | $35.87 | $28.37 |
| Connecticut | $35.75 | $28.56 |
| Florida | $35.69 | $28.99 |
| Illinois | $35.26 | $28.80 |
| Hawaii | $35.01 | $27.42 |
| Maryland | $34.98 | $28.01 |
| Colorado | $34.72 | $27.61 |
| Rhode Island | $34.67 | $27.77 |
| Oregon | $34.41 | $27.38 |
| New Hampshire | $34.35 | $27.40 |
| Puerto Rico | $34.18 | $27.42 |
| Virgin Islands | $34.18 | $27.42 |
| Pennsylvania | $34.12 | $27.58 |
| Montana | $34.07 | $27.39 |
| Michigan | $34.02 | $27.75 |
| Georgia | $33.88 | $27.50 |
| Texas | $33.88 | $27.30 |
| Delaware | $33.86 | $27.26 |
| Nevada | $33.80 | $27.12 |
| Wyoming | $33.63 | $26.95 |
| Arizona | $33.46 | $26.98 |
| New Mexico | $33.41 | $27.28 |
| Virginia | $33.37 | $26.81 |
| Minnesota | $33.24 | $26.37 |
| West Virginia | $33.21 | $27.41 |
| Utah | $33.18 | $26.90 |
| Vermont | $33.12 | $26.51 |
| Louisiana | $33.11 | $27.00 |
| North Dakota | $33.08 | $26.40 |
| Missouri | $33.06 | $26.92 |
| Ohio | $33.04 | $26.94 |
| South Dakota | $32.96 | $26.28 |
| Maine | $32.91 | $26.53 |
| South Carolina | $32.90 | $26.73 |
| North Carolina | $32.66 | $26.43 |
| Kentucky | $32.59 | $26.65 |
| Oklahoma | $32.41 | $26.44 |
| Wisconsin | $32.41 | $26.01 |
| Indiana | $32.33 | $26.14 |
| Idaho | $32.23 | $26.08 |
| Tennessee | $32.20 | $26.13 |
| Nebraska | $32.10 | $25.94 |
| Kansas | $32.09 | $26.05 |
| Iowa | $32.04 | $25.93 |
| Mississippi | $31.96 | $26.21 |
| Alabama | $31.84 | $26.00 |
| Arkansas | $31.56 | $25.83 |

## Related codes

- 99424: Principal care management services, first 30 minutes per month, physician or QHP — https://www.med-reveal.com/rates/99424-cpt-fee-schedule
- 99425: Principal care management services, each additional 30 minutes per month, physician or QHP (add-on) — https://www.med-reveal.com/rates/99425-cpt-fee-schedule
- 99426: Principal care management services, first 30 minutes per month, clinical staff — https://www.med-reveal.com/rates/99426-cpt-fee-schedule
- 99427: Principal care management services, each additional 30 minutes per month, clinical staff (add-on) — https://www.med-reveal.com/rates/99427-cpt-fee-schedule
- 99439: Chronic care management services, non-complex, each additional 20 minutes per month (add-on) — https://www.med-reveal.com/rates/99439-cpt-fee-schedule
- 99484: General behavioral health integration care management, first 20 minutes per month — https://www.med-reveal.com/rates/99484-cpt-fee-schedule
- 99487: Complex chronic care management services, first 60 minutes per month — https://www.med-reveal.com/rates/99487-cpt-fee-schedule
- 99489: Complex chronic care management services, each additional 30 minutes per month (add-on) — https://www.med-reveal.com/rates/99489-cpt-fee-schedule

Commercial negotiated rates for G0318 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules