# HCPCS G0558: Advanced primary care management, level 3 (2 or more chronic conditions, Qualified Medicare Beneficiary)

Medicare HCPCS G0558 pays $117.24 in a non-facility setting and $72.81 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $107.19 in Arkansas to $147.06 in Alaska, a 37% spread.

Web page: https://www.med-reveal.com/rates/G0558-hcpcs-fee-schedule
Section: Evaluation and Management

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $117.24 |
| National facility | $72.81 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $147.06 | $99.75 |
| District of Columbia | $130.93 | $78.60 |
| New York | $127.96 | $78.40 |
| California | $127.93 | $75.36 |
| New Jersey | $127.68 | $77.66 |
| Washington | $126.19 | $75.55 |
| Massachusetts | $125.29 | $75.38 |
| Connecticut | $123.62 | $75.77 |
| Hawaii | $123.42 | $72.91 |
| Florida | $121.22 | $76.65 |
| Maryland | $120.72 | $74.41 |
| Colorado | $120.71 | $73.44 |
| Rhode Island | $119.76 | $73.87 |
| Oregon | $119.65 | $72.85 |
| Illinois | $119.15 | $76.22 |
| New Hampshire | $119.09 | $72.85 |
| Puerto Rico | $117.81 | $72.90 |
| Virgin Islands | $117.81 | $72.90 |
| Montana | $117.23 | $72.81 |
| Pennsylvania | $116.84 | $73.33 |
| Nevada | $116.63 | $72.16 |
| Delaware | $116.42 | $72.53 |
| Texas | $116.37 | $72.63 |
| Wyoming | $116.20 | $71.77 |
| Minnesota | $116.08 | $70.37 |
| Georgia | $115.47 | $73.09 |
| Michigan | $115.37 | $73.66 |
| Virginia | $115.08 | $71.41 |
| Arizona | $114.88 | $71.83 |
| North Dakota | $114.86 | $70.43 |
| Vermont | $114.68 | $70.70 |
| South Dakota | $114.58 | $70.15 |
| Utah | $113.38 | $71.62 |
| New Mexico | $113.27 | $72.54 |
| Maine | $113.19 | $70.74 |
| Missouri | $112.44 | $71.68 |
| Louisiana | $112.43 | $71.87 |
| Ohio | $112.27 | $71.71 |
| South Carolina | $112.27 | $71.22 |
| Wisconsin | $112.05 | $69.49 |
| North Carolina | $111.94 | $70.49 |
| West Virginia | $111.44 | $72.84 |
| Indiana | $110.98 | $69.80 |
| Idaho | $110.53 | $69.66 |
| Kentucky | $110.52 | $71.03 |
| Nebraska | $110.32 | $69.32 |
| Oklahoma | $110.20 | $70.53 |
| Tennessee | $110.15 | $69.77 |
| Iowa | $109.94 | $69.29 |
| Kansas | $109.73 | $69.58 |
| Alabama | $108.32 | $69.45 |
| Mississippi | $108.21 | $69.96 |
| Arkansas | $107.19 | $69.03 |

## 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 G0558 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