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)
Billable / valid for submission HCPCS Release 2026Q3
Short description: Pt navigat svs direct/ref
Version history
| Release | Valid from | Valid to | Description | Billable |
|---|---|---|---|---|
| 2026Q3 | 2026-07-01 | current | 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) | yes |
Related codes in G05
- G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)
- G0501 Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)
- G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
- G0508 Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
- G0509 Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
- G0513 Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
- G0514 Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)
- G0516 Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
- G0517 Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
- G0518 Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
- G0519 Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model
- G0520 Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
- G0521 Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model
- G0522 Management of a new patient with dementia, low complexity, for use in cmmi model
- G0523 Management of a new patient with dementia, moderate to high complexity, for use in cmmi model
- G0524 Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model
- G0525 Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
- G0526 Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model
- G0527 Management of established patient with dementia, low complexity, for use in cmmi model
- G0528 Management of established patient with dementia, moderate to high complexity, for use in cmmi model