G2065 Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities
Short descriptor: Clin mang h risk dx 30
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G2065 is the HCPCS Level II code for Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities (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
- 2022-01-01
- Termination Date
- 2021-12-31
- 2026 Maintenance
- No change this year
References
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Reference G2065 with the canonical source and edition:
G2065 — Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities. ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/G2065
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