2025 HCPCS Code G0316

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)

TAGS: separately codes total addition minutes selected prolonged g0316 hospital observation qualified management beyond report inpatient direct healthcare using patient additional physician service 99236 evaluation contact primary
Short DescriptionProlong inpt eval add15 m
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date January 01, 2023
HCPCS Action Effective Date January 01, 2023
HCPCS Pricing Indicator Code 11 - Price established using national rvu's
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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