How To Use HCPCS Code G0022

HCPCS code G0022 describes community health integration services, specifically each additional 30 minutes per calendar month. This code is used to identify and bill for additional time spent by healthcare providers in delivering community health integration services to patients. In this article, we will explore the details of HCPCS code G0022, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G0022?

HCPCS code G0022 is a specific code used to identify and bill for community health integration services. It represents each additional 30 minutes of service provided per calendar month, in addition to the primary code G0019. These services aim to integrate healthcare and social services to improve patient outcomes and overall well-being.

2. Official Description

The official description of HCPCS code G0022 is “Community health integration services, each additional 30 minutes per calendar month (list separately in addition to G0019).” The short description is “Comm hlth intg svs add 30 m.” This description accurately reflects the purpose and nature of the code.

3. Procedure

1. Providers should first identify the primary service provided using HCPCS code G0019, which represents the initial community health integration service.
2. If additional time beyond the initial service is required, the provider can bill for each additional 30 minutes using HCPCS code G0022.
3. The provider must document the specific details of the additional time spent on community health integration services, including the activities performed and the patient’s response or progress.
4. The additional time should be documented separately from the primary service and clearly indicate that it is an add-on service.
5. Providers should ensure that the total time billed for community health integration services does not exceed the maximum allowable time per calendar month.

4. When to use HCPCS code G0022

HCPCS code G0022 should be used when healthcare providers provide additional 30 minutes of community health integration services beyond the initial service represented by HCPCS code G0019. It is important to note that this code can only be used in conjunction with the primary code G0019 and cannot be billed independently.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0022, healthcare providers must ensure that the following guidelines and documentation requirements are met:

• The primary service represented by HCPCS code G0019 must be billed first before using code G0022 for additional time.
• The additional time must be documented separately and clearly indicate that it is an add-on service.
• The documentation should include the specific activities performed during the additional time and the patient’s response or progress.
• Providers should ensure that the total time billed for community health integration services does not exceed the maximum allowable time per calendar month.

6. Historical Information and Code Maintenance

HCPCS code G0022 was added to the Healthcare Common Procedure Coding System on January 01, 2024. As of its addition, there have been no maintenance actions taken for this code. The code has an effective date of January 01, 2024, and is currently active for use in medical billing and coding.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G0022 may vary. It is important for healthcare providers to check with the respective payers to determine if this code is payable and the specific coverage guidelines. The pricing indicator code for G0022 is 13, which indicates that the price for this service is established by carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS is priced under one methodology.

8. Examples

Here are five examples of scenarios where HCPCS code G0022 should be billed:

1. A healthcare provider spends an additional 30 minutes providing community health integration services to a patient beyond the initial service represented by G0019.
2. A patient requires an extended session of community health integration services, and the provider spends an additional 60 minutes beyond the initial service.
3. A healthcare provider delivers community health integration services to multiple patients in a group setting, and each patient receives an additional 30 minutes of service beyond the initial session.
4. A patient with complex healthcare needs requires ongoing community health integration services, and the provider spends an additional 30 minutes per week beyond the initial service.
5. A healthcare provider provides community health integration services to a patient in a remote location and spends an additional 30 minutes beyond the initial service to ensure comprehensive care.