Question 1

What is HCPCS code G0550?

Accepted Answer

HCPCS code G0550 is "Phone/inter for dx/treat >5m". Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patient's treating/requesting practitioner, 5 minutes or more of medical consultative time

Question 2

What category is G0550 in?

Accepted Answer

G0550 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0550?

Accepted Answer

Use G0550 when billing for phone/inter for dx/treat >5m. 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 G0550 covered by Medicare?

Accepted Answer

Coverage for G0550 (Phone/inter for dx/treat >5m) 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 G0550?

Accepted Answer

Documentation for G0550 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).