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Billing code G0023 · Physician & professional

G0023 Medicaid reimbursement rate by state (2026)

Principal illness navigation services by certified or.... Medicaid pays a median of $68.58 for G0023 across 8 states, from $18.51 in Kansas to $122.54 in Montana.

Data as of Oct 5, 20268 statesEvery rate links to its official source

States publishing
8
National median
$68.58units vary by state
Lowest
$18.51Kansas
Highest
$122.54Montana
Answer

What does Medicaid pay for G0023?

8 state Medicaid programs publish a fee-for-service rate for G0023. The national median is $68.58 (units differ between states). Montana pays the most, $122.54, and Kansas the least, $18.51, a 6.6x spread.

Medicare (non-facility, 2026 physician fee schedule): $81.08–$100.09 depending on the state's Medicare locality.

State ranking

G0023 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2026-07-01$122.54——Not classified—
2New Mexico Source · since 2024-01-01$76.82——Plans must pay at least this—
3Vermont Source · since 2026-01-01$72.87——Not classified—
7Washington Source · since 2026-01-01$23.74——Plans negotiate; applies out of network—
8Kansas Source · since 2024-01-01$18.51——Not classified—
See all 8 states for G0023 — start free

3 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track G0023 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for G0023, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 5 of the 8 states list more than one rate for G0023, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. None of the 8 schedules prints a separate unit for G0023, so each amount is a flat payment for one service as the code defines it.
  • Per hour. G0023 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. Medicare amounts exist for G0023, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why G0023 rates differ between states

Published rates for G0023 run from $18.51 in Kansas to $122.54 in Montana, a 6.6x gap in the same unit. Half the states pay more than the median of $68.58 and half pay less. The usual reasons for a spread like this in physician & professional rates:

  • Each state sets its own physician conversion factor or fee for every code, and many update them on a state budget cycle rather than on Medicare's calendar.
  • Modifiers such as professional or technical component, bilateral, multiple procedure and assistant at surgery change the amount paid, and states apply them with their own percentages.
  • Many schedules pay differently by place of service (office versus facility) and by practitioner, and nurse practitioners and physician assistants are often paid a percentage of the physician amount.

Timing matters too. 6 states set the current rate for G0023 in 2026 or later. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for G0023

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For G0023, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (4 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (1 state). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Montana managed care.

Billing

Units and billing for G0023

G0023 is a HCPCS Level II professional services code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. G codes describe professional services and procedures that have no CPT code, or that payers define more narrowly. Many are timed, so check the unit before comparing.

Practitioners who are not physicians are often paid a reduced percentage of the published amount, so check the schedule for the reduction that applies to your provider type. Where a state publishes separate facility and non-facility amounts, the non-facility (office) amount is usually higher because the practice carries the overhead.

Medicare's 2026 physician fee schedule pays $81.08–$100.09 for G0023 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for G0023?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $68.58. Montana pays the most ($122.54) and Kansas the least ($18.51).

Which state pays the highest Medicaid rate for G0023?

Montana, at $122.54, effective 2026-07-01.

Which state pays the lowest Medicaid rate for G0023?

Kansas, at $18.51, effective 2024-01-01.

What unit is G0023 billed in?

None of the 8 schedules prints a separate unit for G0023, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for G0023?

Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.