G9038 – Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care planning; condition for which specialist is taking a co-management role; condition expected to last at least 3 months; comprehensive care plan established, implemented, revised or monitored in partnership with co-managing clinicians; ongoing communication and care coordination between co-managing clinicians furnishing care

Long description

Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care planning; condition for which specialist is taking a co-management role; condition expected to last at least 3 months; comprehensive care plan established, implemented, revised or monitored in partnership with co-managing clinicians; ongoing communication and care coordination between co-managing clinicians furnishing care

Short description

Co-management services

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

Z2 Undefined codes

Added

July 1, 2024

Last change

July 1, 2025 – No change

Termination date

June 30, 2025

Nearby G codes

• G9018 – Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project)
• G9019 – Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)
• G9020 – Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)
• G9033 – Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)
• G9034 – Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project)
• G9035 – Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)
• G9036 – Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)
• G9037 – Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified health care professional for the care of the patient (i.e. not for professional education or scheduling) and may include subsequent follow up on the specialist's recommendations; 30 minutes
• G9050 – Oncology; primary focus of visit; work-up, evaluation, or staging at the time of cancer diagnosis or recurrence (for use in a medicare-approved demonstration project)
• G9051 – Oncology; primary focus of visit; treatment decision-making after disease is staged or restaged, discussion of treatment options, supervising/coordinating active cancer directed therapy or managing consequences of cancer directed therapy (for use in a medicare-approved demonstration project)
• G9052 – Oncology; primary focus of visit; surveillance for disease recurrence for patient who has completed definitive cancer-directed therapy and currently lacks evidence of recurrent disease; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)
• G9053 – Oncology; primary focus of visit; expectant management of patient with evidence of cancer for whom no cancer directed therapy is being administered or arranged at present; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)
• G9054 – Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a medicare-approved demonstration project)
• G9055 – Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)
• G9056 – Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)
• G9057 – Oncology; practice guidelines; management differs from guidelines as a result of patient enrollment in an institutional review board approved clinical trial (for use in a medicare-approved demonstration project)