How To Use HCPCS Code G2083

HCPCS code G2083 describes an office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, including 2 hours post-administration observation. This code was added to the Healthcare Common Procedure Coding System on January 01, 2020, and has a coverage code of C, which indicates that carrier judgment is required for reimbursement. The pricing indicator code for G2083 is 13, which means that the price is established by carriers based on individual determination and carrier discretion.

1. What is HCPCS G2083?

HCPCS code G2083 is used to identify an office or other outpatient visit for the evaluation and management of an established patient. This visit requires the supervision of a physician or other qualified health care professional and includes the provision of greater than 56 mg esketamine nasal self-administration, along with 2 hours of post-administration observation.

2. Official Description

The official description of HCPCS code G2083 is “Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation.” The short description is “Visit esketamine, > 56m.”

3. Procedure

1. The provider begins by evaluating and managing an established patient.
2. During the visit, the provider determines that the patient requires esketamine nasal self-administration.
3. The provider supervises the administration of greater than 56 mg of esketamine nasal spray.
4. Following the administration, the patient is observed for a period of 2 hours to monitor for any adverse reactions or side effects.

4. When to use HCPCS code G2083

HCPCS code G2083 should be used when an established patient requires an office or other outpatient visit for evaluation and management, and the visit includes the supervision of a physician or other qualified health care professional. Additionally, the visit must involve the provision of greater than 56 mg esketamine nasal self-administration, along with 2 hours of post-administration observation.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G2083, healthcare providers should ensure that the following documentation is included:

• Documentation of the evaluation and management services provided during the visit.
• Documentation of the supervision of the physician or other qualified health care professional.
• Documentation of the provision of greater than 56 mg esketamine nasal self-administration.
• Documentation of the 2-hour post-administration observation period.

6. Historical Information and Code Maintenance

HCPCS code G2083 was added to the Healthcare Common Procedure Coding System on January 01, 2020. As of now, no maintenance actions have been taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G2083 is determined by carrier judgment. Medicare and other insurance providers may have their own guidelines and policies regarding reimbursement for this code. The pricing of this service is established by carriers based on individual determination and carrier discretion.

8. Examples

Here are five examples of scenarios where HCPCS code G2083 should be billed:

1. A patient with a history of treatment-resistant depression visits their psychiatrist for an evaluation and management session. During the visit, the psychiatrist determines that the patient would benefit from esketamine nasal self-administration. The psychiatrist supervises the administration of 60 mg of esketamine nasal spray and observes the patient for 2 hours post-administration.
2. An established patient with post-traumatic stress disorder (PTSD) visits their therapist for an evaluation and management session. The therapist decides to incorporate esketamine nasal self-administration as part of the patient’s treatment plan. The therapist supervises the administration of 70 mg of esketamine nasal spray and monitors the patient for 2 hours after the administration.
3. A patient with major depressive disorder visits their primary care physician for an evaluation and management session. The physician determines that the patient would benefit from esketamine nasal self-administration. The physician supervises the administration of 80 mg of esketamine nasal spray and observes the patient for 2 hours post-administration.
4. An established patient with treatment-resistant bipolar disorder visits their psychiatrist for an evaluation and management session. The psychiatrist decides to incorporate esketamine nasal self-administration into the patient’s treatment plan. The psychiatrist supervises the administration of 90 mg of esketamine nasal spray and monitors the patient for 2 hours after the administration.
5. A patient with persistent depressive disorder visits their therapist for an evaluation and management session. The therapist determines that the patient would benefit from esketamine nasal self-administration. The therapist supervises the administration of 100 mg of esketamine nasal spray and observes the patient for 2 hours post-administration.