# HCPCS G0556: Advanced primary care management, level 1 (0-1 chronic conditions)

Medicare HCPCS G0556 pays $16.37 in a non-facility setting and $11.02 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $15.01 in Arkansas to $20.72 in Alaska, a 38% spread.

Web page: https://www.med-reveal.com/rates/G0556-hcpcs-fee-schedule
Section: Evaluation and Management

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $16.37 |
| National facility | $11.02 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $20.72 | $15.03 |
| District of Columbia | $18.20 | $11.91 |
| New York | $17.85 | $11.89 |
| New Jersey | $17.77 | $11.76 |
| California | $17.70 | $11.38 |
| Washington | $17.52 | $11.43 |
| Massachusetts | $17.41 | $11.41 |
| Connecticut | $17.24 | $11.48 |
| Hawaii | $17.09 | $11.02 |
| Florida | $17.02 | $11.66 |
| Maryland | $16.84 | $11.27 |
| Colorado | $16.79 | $11.10 |
| Illinois | $16.76 | $11.59 |
| Rhode Island | $16.70 | $11.17 |
| Oregon | $16.64 | $11.02 |
| New Hampshire | $16.58 | $11.02 |
| Puerto Rico | $16.44 | $11.03 |
| Virgin Islands | $16.44 | $11.03 |
| Montana | $16.37 | $11.02 |
| Pennsylvania | $16.34 | $11.10 |
| Nevada | $16.26 | $10.91 |
| Delaware | $16.25 | $10.97 |
| Texas | $16.25 | $10.99 |
| Michigan | $16.19 | $11.17 |
| Wyoming | $16.19 | $10.85 |
| Georgia | $16.17 | $11.07 |
| Minnesota | $16.11 | $10.61 |
| Virginia | $16.05 | $10.79 |
| Arizona | $16.04 | $10.86 |
| North Dakota | $15.97 | $10.63 |
| Vermont | $15.96 | $10.67 |
| South Dakota | $15.92 | $10.58 |
| New Mexico | $15.89 | $10.99 |
| Utah | $15.86 | $10.83 |
| Maine | $15.79 | $10.68 |
| Louisiana | $15.76 | $10.88 |
| Missouri | $15.75 | $10.85 |
| Ohio | $15.73 | $10.85 |
| South Carolina | $15.71 | $10.77 |
| West Virginia | $15.69 | $11.05 |
| North Carolina | $15.63 | $10.65 |
| Wisconsin | $15.60 | $10.48 |
| Indiana | $15.49 | $10.53 |
| Kentucky | $15.49 | $10.74 |
| Idaho | $15.43 | $10.51 |
| Oklahoma | $15.43 | $10.66 |
| Nebraska | $15.39 | $10.45 |
| Tennessee | $15.39 | $10.53 |
| Iowa | $15.34 | $10.45 |
| Kansas | $15.33 | $10.50 |
| Mississippi | $15.17 | $10.57 |
| Alabama | $15.16 | $10.48 |
| Arkansas | $15.01 | $10.42 |

## 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 G0556 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