Showing codes G0504 (Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)) — G0910 (Most recent hemoglobin level <= 12.0 g/dl)

G0504 - Init/sub psych care add 30 m
Long description: Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)
Code added date: 20170101.
Code effective date: 20180101.
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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G0505 - Cog/func assessment outpt
Long description: Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home
Code added date: 20170101.
Code effective date: 20180101.
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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G0506 - Comp asses care plan ccm svc
Long description: Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
Code added date: 20170101.
Code effective date: 20170101.
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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G0507 - Care manage serv minimum 20
Long description: Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with 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, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team
Code added date: 20170101.
Code effective date: 20180101.
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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G0508 - Crit care telehea consult 60
Long description: Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
Code added date: 20170101.
Code effective date: 20170101.
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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G0509 - Crit care telehea consult 50
Long description: Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
Code added date: 20170101.
Code effective date: 20170101.
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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G0511 - Ccm/bhi by rhc/fqhc 20min mo
Long description: Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month
Code added date: 20180101.
Code effective date: 20180101.
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).
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G0512 - Cocm by rhc/fqhc 60 min mo
Long description: Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month
Code added date: 20180101.
Code effective date: 20180101.
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).
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G0513 - Prolong prev svcs, first 30m
Long description: Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
Code added date: 20180101.
Code effective date: 20180101.
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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G0514 - Prolong prev svcs, addl 30m
Long description: Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)
Code added date: 20180101.
Code effective date: 20180101.
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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G0515 - Cognitive skills development
Long description: Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
Code added date: 20180101.
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).
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G0516 - Insert drug del implant, >=4
Long description: Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
Code added date: 20180101.
Code effective date: 20180401.
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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G0517 - Remove drug implant
Long description: Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
Code added date: 20180101.
Code effective date: 20180101.
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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G0518 - Remove w insert drug implant
Long description: Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
Code added date: 20180101.
Code effective date: 20180101.
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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G0519 - New pt-cg dyad dem low cmplx
Long description: Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0520 - New pt-cg dyad dem mod cmplx
Long description: Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0521 - New pt-cg dyad dem hig cmplx
Long description: Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0522 - Mgt nw pt dementia low cmplx
Long description: Management of a new patient with dementia, low complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0523 - Mgt nw pt dem mod-high cmplx
Long description: Management of a new patient with dementia, moderate to high complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0524 - Est pt-cg dyad dem low cmplx
Long description: Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0525 - Est pt-cg dyad dem mod cmplx
Long description: Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0526 - Est pt-cg dyad dem hig cmplx
Long description: Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0527 - Mgt est pt dmentia low cmplx
Long description: Management of established patient with dementia, low complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0528 - Mgt est pt dem mod-hi cmplx
Long description: Management of established patient with dementia, moderate to high complexity, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0529 - In home respite care, 4 hr u
Long description: In-home respite care, 4-hour unit, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0530 - Adult daycare center, 8 hr u
Long description: Adult day center, 8-hour unit, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0531 - Fclty-based respite, 24 hr u
Long description: Facility-based respite, 24-hour unit, for use in cmmi model
Code added date: 20240701.
Code effective date: 20240701.
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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G0659 - Drug test def simple all cl
Long description: Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes
Code added date: 20170101.
Code effective date: 20170101.
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: C (A code denoting Medicare coverage status).
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G0908 - Hgb > 12 g/dl
Long description: Most recent hemoglobin (hgb) level > 12.0 g/dl
Code added date: 20120101.
Code effective date: 20150101.
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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G0909 - Hbg not doc
Long description: Hemoglobin level measurement not documented, reason not given
Code added date: 20120101.
Code effective date: 20150101.
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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G0910 - Hgb <= 12 g/dl
Long description: Most recent hemoglobin level <= 12.0 g/dl
Code added date: 20120101.
Code effective date: 20150101.
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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