Question 1

What is HCPCS code G0504?

Accepted Answer

HCPCS code G0504 is "Init/sub psych care add 30 m". 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)

Question 2

What category is G0504 in?

Accepted Answer

G0504 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0504?

Accepted Answer

Use G0504 when billing for init/sub psych care add 30 m. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G0504 covered by Medicare?

Accepted Answer

Coverage for G0504 (Init/sub psych care add 30 m) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G0504?

Accepted Answer

Documentation for G0504 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).