Showing codes G0309 (Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor, including system activation) — G0380 (Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment))

G0309 - Rem/inser glu sensor dif sit
Long description: Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor, including system activation
Code added date: 20220701.
Code effective date: 20230101.
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).
HTML    PDF

G0310 - Immunize counsel 5-15 min
Long description: Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)
Code added date: 20220511.
Code effective date: 20220511.
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: I (A code denoting Medicare coverage status).
HTML    PDF

G0311 - Immunize counsel 16-30 mins
Long description: Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid billing purposes)
Code added date: 20220511.
Code effective date: 20220511.
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: I (A code denoting Medicare coverage status).
HTML    PDF

G0312 - Immunize couns < 21yr 5-15 m
Long description: Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)
Code added date: 20220511.
Code effective date: 20220511.
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: I (A code denoting Medicare coverage status).
HTML    PDF

G0313 - Immunize couns < 21yr 6-30 m
Long description: Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)
Code added date: 20220511.
Code effective date: 20220511.
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: I (A code denoting Medicare coverage status).
HTML    PDF

G0314 - Counsel immune <21 16-30 m
Long description: Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)
Code added date: 20220511.
Code effective date: 20220511.
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: I (A code denoting Medicare coverage status).
HTML    PDF

G0315 - Counsel immune <21 5-15 m
Long description: Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)
Code added date: 20220511.
Code effective date: 20220511.
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: I (A code denoting Medicare coverage status).
HTML    PDF

G0316 - Prolong inpt eval add15 m
Long description: Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). (do not report g0316 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418, 99415, 99416). (do not report g0316 for any time unit less than 15 minutes)
Code added date: 20230101.
Code effective date: 20230101.
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).
HTML    PDF

G0317 - Prolong nursin fac eval 15m
Long description: Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99306, 99310 for nursing facility evaluation and management services). (do not report g0317 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418). (do not report g0317 for any time unit less than 15 minutes)
Code added date: 20230101.
Code effective date: 20230101.
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).
HTML    PDF

G0318 - Prolong home eval add 15m
Long description: Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes)
Code added date: 20230101.
Code effective date: 20230101.
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).
HTML    PDF

G0320 - Two-way audio and video hhs
Long description: Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system
Code added date: 20230101.
Code effective date: 20230101.
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).
HTML    PDF

G0321 - Audio-only hhs
Long description: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system
Code added date: 20230101.
Code effective date: 20230101.
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).
HTML    PDF

G0322 - Home h physio data collec tr
Long description: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring)
Code added date: 20230101.
Code effective date: 20230101.
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).
HTML    PDF

G0323 - Care manage beh svs 20mins
Long description: Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team)
Code added date: 20230101.
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).
HTML    PDF

G0327 - Colon ca scrn;bld-bsd biomrk
Long description: Colorectal cancer screening; blood-based biomarker
Code added date: 20210701.
Code effective date: 20210701.
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).
HTML    PDF

G0328 - Fecal blood scrn immunoassay
Long description: Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous
Code added date: 20040101.
Code effective date: 20040101.
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).
HTML    PDF

G0329 - Electromagntic tx for ulcers
Long description: Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care
Code added date: 20040701.
Code effective date: 20040701.
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).
HTML    PDF

G0330 - Facility svs dental rehab
Long description: Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room
Code added date: 20230101.
Code effective date: 20240101.
Pricing Indicator Code(s): 53 ; (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).
HTML    PDF

G0333 - Dispense fee initial 30 day
Long description: Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary
Code added date: 20060101.
Code effective date: 20060101.
Pricing Indicator Code(s): 46 ; (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).
HTML    PDF

G0337 - Hospice evaluation preelecti
Long description: Hospice evaluation and counseling services, pre-election
Code added date: 20050101.
Code effective date: 20050101.
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).
HTML    PDF

G0339 - Robot lin-radsurg com, first
Long description: Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment
Code added date: 20040101.
Code effective date: 20140101.
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).
HTML    PDF

G0340 - Robt lin-radsurg fractx 2-5
Long description: Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment
Code added date: 20040101.
Code effective date: 20140101.
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).
HTML    PDF

G0341 - Percutaneous islet celltrans
Long description: Percutaneous islet cell transplant, includes portal vein catheterization and infusion
Code added date: 20041001.
Code effective date: 20041001.
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: D (A code denoting Medicare coverage status).
HTML    PDF

G0342 - Laparoscopy islet cell trans
Long description: Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion
Code added date: 20041001.
Code effective date: 20041001.
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: D (A code denoting Medicare coverage status).
HTML    PDF

G0343 - Laparotomy islet cell transp
Long description: Laparotomy for islet cell transplant, includes portal vein catheterization and infusion
Code added date: 20041001.
Code effective date: 20041001.
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: D (A code denoting Medicare coverage status).
HTML    PDF

G0364 - Bone marrow aspirate &biopsy
Long description: Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service
Code added date: 20050101.
Code effective date: 20180101.
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).
HTML    PDF

G0365 - Vessel mapping hemo access
Long description: Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)
Code added date: 20050101.
Code effective date: 20200101.
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).
HTML    PDF

G0372 - Md service required for pmd
Long description: Physician service required to establish and document the need for a power mobility device
Code added date: 20051025.
Code effective date: 20051025.
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: D (A code denoting Medicare coverage status).
HTML    PDF

G0378 - Hospital observation per hr
Long description: Hospital observation service, per hour
Code added date: 20060101.
Code effective date: 20060101.
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: D (A code denoting Medicare coverage status).
HTML    PDF

G0379 - Direct refer hospital observ
Long description: Direct admission of patient for hospital observation care
Code added date: 20060101.
Code effective date: 20100101.
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: D (A code denoting Medicare coverage status).
HTML    PDF

G0380 - Lev 1 hosp type b ed visit
Long description: Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
Code added date: 20070101.
Code effective date: 20080101.
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).
HTML    PDF