Showing codes G0084 (Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)) — G0141 (Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician)

G0084 - Care man h v ext pt 60 m
Long description: Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0085 - Care man h v ext pt 75 m
Long description: Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0086 - Care man home care plan 30 m
Long description: Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0087 - Care man home care plan 60 m
Long description: Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0088 - Adm iv drug 1st home visit
Long description: Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0089 - Adm subq drug 1st home visit
Long description: Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0090 - Adm iv chemo 1st home visit
Long description: Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0101 - Ca screen;pelvic/breast exam
Long description: Cervical or vaginal cancer screening; pelvic and clinical breast examination
Code added date: 19980101.
Code effective date: 19980101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0102 - Prostate ca screening; dre
Long description: Prostate cancer screening; digital rectal examination
Code added date: 20000101.
Code effective date: 20000101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0103 - Psa screening
Long description: Prostate cancer screening; prostate specific antigen test (psa)
Code added date: 20000101.
Code effective date: 20070101.
Pricing Indicator Code(s): 21 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0104 - Ca screen;flexi sigmoidscope
Long description: Colorectal cancer screening; flexible sigmoidoscopy
Code added date: 19980101.
Code effective date: 19980101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0105 - Colorectal scrn; hi risk ind
Long description: Colorectal cancer screening; colonoscopy on individual at high risk
Code added date: 19980101.
Code effective date: 19980101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0106 - Colon ca screen;barium enema
Long description: Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema
Code added date: 19980101.
Code effective date: 19980101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0108 - Diab manage trn per indiv
Long description: Diabetes outpatient self-management training services, individual, per 30 minutes
Code added date: 19980701.
Code effective date: 20010101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0109 - Diab manage trn ind/group
Long description: Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
Code added date: 19980701.
Code effective date: 20010101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0117 - Glaucoma scrn hgh risk direc
Long description: Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
Code added date: 20020101.
Code effective date: 20031001.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0118 - Glaucoma scrn hgh risk direc
Long description: Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0120 - Colon ca scrn; barium enema
Long description: Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
Code added date: 19980101.
Code effective date: 19980101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0121 - Colon ca scrn not hi rsk ind
Long description: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Code added date: 19980101.
Code effective date: 20240101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0122 - Colon ca scrn; barium enema
Long description: Colorectal cancer screening; barium enema
Code added date: 19980101.
Code effective date: 19980101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: M (A code denoting Medicare coverage status).
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G0123 - Screen cerv/vag thin layer
Long description: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s): 21 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0124 - Screen c/v thin layer by md
Long description: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s): 11 , 21 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0127 - Trim nail(s)
Long description: Trimming of dystrophic nails, any number
Code added date: 19980101.
Code effective date: 19980101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0128 - Corf skilled nursing service
Long description: Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s): 99 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0129 - Php/iop ot service
Long description: Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization or intensive outpatient treatment program, per session (45 minutes or more)
Code added date: 20000401.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0130 - Single energy x-ray study
Long description: Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)
Code added date: 19980701.
Code effective date: 19980701.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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G0136 - Adm of soc dtr assess 5-15 m
Long description: Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0137 - Inten outpt svs,min 9 pr 7 d
Long description: Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skills of a qualified occupational therapist; services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individual's condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individual's care and treatment); diagnostic services; and such other items and services (excluding meals and transportation) that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services in accordance with a physician certification and plan of treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0138 - Iv cipaglucosidase alfa-atga
Long description: Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga
Code added date: 20240401.
Code effective date: 20240401.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0140 - Nav srv peer sup 60 min pr m
Long description: Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities: person-centered interview, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered interview to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes, including understanding cultural and linguistic factors, and including unmet sdoh needs (that are not billed separately). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish the person-centered goals in the practitioner's treatment plan. identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services. practitioner, home, and community-based care communication. ++ assist the patient in communicating with their practitioners, home-, and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) as needed to address sdoh need(s). health education. helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, preferences, and sdoh need(s), and educating the patient (and caregiver if applicable) on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services (as needed), in ways that are more likely to promote personalized and effective treatment of their condition. developing and proposing strategies to help meet person-centered treatment goals and supporting the patient in using chosen strategies to reach person-centered treatment goals. facilitating and providing social and emotional support to help the patient cope with the condition, sdoh need(s), and adjust daily routines to better meet person-centered diagnosis and treatment goals. leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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G0141 - Scr c/v cyto,autosys and md
Long description: Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
Code added date: 19990101.
Code effective date: 19990101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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