HCPCS Code G0535

Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and goals; each additional 30 minutes of services (provision of the services by a medicare-enrolled opioid treatment program); (list separately in addition to each primary code)
Short DescriptionPt navigat svs direct/ref
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2025
Code Added DateJanuary 01, 2025
Pricing Indicator13 = Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)
Type of Service1 = Medical care