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)
Short descriptor: Pt navigat svs direct/ref
Look up G0535 alongside ICD-10-CM diagnoses, the HCPCS Table of Drugs, and the AI coding assistant.
G0535 is the HCPCS Level II code for 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) (2026). It belongs to Section G — Procedures / Professional Services (Temporary). Under Medicare, its coverage status is: Carrier judgment. Part B pricing methodology: Priced by carriers (physician fee schedule).
Classification & CMS Attributes
- Medicare Coverage
- Carrier judgment (code C)
- Part B Pricing
- Priced by carriers (physician fee schedule) (indicator 13)
- Type of Service
- Medical care
- Effective Date
- 2025-01-01
- 2026 Maintenance
- No change this year
References
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Reference G0535 with the canonical source and edition:
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). ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/G0535
Canonical URL: https://icd10codingpro.com/hcpcs-codes/G0535