G0257 – Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility

HCPCS Level II code · G codes: Procedures / Professional Services (Temporary)

Active code Special coverage instructions apply

HCPCS codeG0257
Long description
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility
Short description
Unsched dialysis esrd pt hos
Pricing indicator
00 Not separately priced by Part B (bundled, not covered or Part A only)
Medicare coverage
D Special coverage instructions apply
BETOS category
P6D Minor procedures - other (Non-Medicare fee schedule)
Added
January 1, 2003
Last change
January 1, 2003 – No change

Frequently asked questions

What is HCPCS code G0257?

G0257 is a HCPCS Level II code for unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility.

Does Medicare cover G0257?

The HCPCS file lists coverage code D: Special coverage instructions apply. Coverage and payment also depend on local coverage determinations and the patient’s plan.

Nearby G codes

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.