HCPCS code G0313
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)
What G0313 means
G0313 (Immunize couns < 21yr 6-30 m) belongs to the HCPCS Level II G series (Procedures / Professional Services (Temporary)). Its Medicare coverage status is Not payable by Medicare. This code is not payable by Medicare. Another code is usually used to report the item or service to Medicare, although other payers may accept it.
Part B pricing: Value not established.
Code details
- Short description
- Immunize couns < 21yr 6-30 m
- Coverage code
- I = Not payable by Medicare
- Pricing indicator
- 99 = Value not established
- Multiple pricing indicator
- 9 = Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established(pricing indicator is '99')
- Type of service
- 1 = Medical care
- Action code
- N = No maintenance for this code
- Action effective date
- May 11, 2022
- Code added date
- May 11, 2022
- Data year
- 2026
Questions about G0313
What is HCPCS code G0313?
HCPCS code G0313 is a Level II code in the G series (Procedures / Professional Services (Temporary)). Its full description is: "Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)"
Is G0313 a CPT code?
No. G0313 is a HCPCS Level II code maintained by CMS, not a CPT (Level I) code from the American Medical Association. People often search for it as a CPT code because both code sets are reported on the same claims.
Does Medicare cover HCPCS code G0313?
The Medicare coverage code for G0313 is "Not payable by Medicare". This code is not payable by Medicare. Another code is usually used to report the item or service to Medicare, although other payers may accept it.
When was HCPCS code G0313 added?
G0313 was added to the HCPCS code set on May 11, 2022. The most recent action on it (No maintenance for this code) took effect on May 11, 2022.
Nearby G codes
All G codes- G0308Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor, including system activation and patient training
- G0309Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor, including system activation
- G0310Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)
- G0311Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid billing purposes)
- G0312Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)
- G0314Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)
- G0315Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)
- G0316Prolonged 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)
- G0317Prolonged nursing facility 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 99306, 99310 for nursing facility evaluation and management services). (do not report g0317 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418). (do not report g0317 for any time unit less than 15 minutes)
- G0318Prolonged home or residence 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 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes)