{
    "code": "G0402",
    "coding_system": "HCPCS",
    "canonical_url": "https://localishealth.com/hcpcs/G0402/2021/A",
    "release_specific_url": "https://localishealth.com/hcpcs/G0402/2021/C",
    "description": "The one-time Initial Preventive Physical Examination available within the first 12 months of Medicare Part B enrollment. It covers a review of medical and social history, vital signs, vision screening, a written screening schedule, and counseling — not the treatment of a specific complaint or a hands-on physical exam.",
    "answer": {
        "question": "How much did Medicare pay for HCPCS G0402 in Q3 2021?",
        "text": "Medicare paid $169.58 for HCPCS G0402 in the office (non-facility) setting and $135.73 in a facility under the Q3 2021 Physician Fee Schedule, effective July 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2021, when it increased 0.6%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2021,
        "quarter": "C",
        "label": "Q3 2021",
        "effective": "July 1 – September 30, 2021",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 169.58,
        "facility": 135.73,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 2.6,
        "practice_expense_non_facility": 2.11,
        "practice_expense_facility": 1.14,
        "malpractice": 0.15
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.8931,
    "source": {
        "label": "Physician relative value file (Q3 2021)",
        "cms_url": "https://www.cms.gov/files/zip/rvu21c-updated-6302021.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2021/C",
        "file": "PPRRVU21_JUL.csv",
        "row": 1608,
        "sha256": "ee14b5306942acfe4554d2d7cf3fe95d7b1a0f41fc7a0445bc2d06df857dd7b6"
    },
    "modified_at": "2026-08-04T03:10:45+00:00"
}