2025 HCPCS Code G2064
Comprehensive care management services for a single high-risk disease, e.g., principal care management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities
TAGS: month professional complex unusually medication comorbidities development least minutes frequent principal focus condition single hospitalization qualified chronic calendar management comprehensive severity revision lasting patient requires recent physician cause health sufficient adjustments place| Notice | HCPCS G2064 terminated on December 31, 2021. |
| Short Description | Md mang high risk dx 30 |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Coverage Code | C - Carrier judgment |
| HCPCS Code Added Date | January 01, 2020 |
| HCPCS Action Effective Date | January 01, 2022 |
| HCPCS Pricing Indicator Code | 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion) |
| HCPCS Type Of Service Code | 1 - Medical care |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Anesthesia Base Unit Quantity | 0 |
| HCPCS Coverage Issues Manual Reference Section Number |
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