This page addresses follow-up questions and additional information pertinent to our webinar
The 2025 CMS Coding Updates ‘G’ Codes and More.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: Can we bill code G0553 for monthly treatment management services related to a DMHT device if the patient stops using the device?
A: No. CMS stated in the 2025 PFS Final Rule “HCPCS codes G0553 and G0554 should only be billed when there is ongoing use of the DMHT device and should not be billed in cases where the patient discontinues use of the DMHT device”. Page 590.
Q: Can we bill for an ASCVD Risk Assessment (G0537) on a patient who had a stroke 3 years ago?
A: No – CMS stated in the 2025 PFS Final Rule that the ASCVD risk assessment will not be separately billable for patients with a cardiovascular disease diagnosis or those who have history of a heart attack or stroke.
Q: Can a non-physician practitioner (NPP) bill 99223 with the add-on code G0545 for visit complexity due to an infectious disease?
A: Yes – CMS stated in the 2025 PFS Final Rule “We maintain the expectation that HCPCS code G0545 will be reported by practitioners who have the requisite specialized infectious disease training, including but not limited to physicians, nurse practitioners, physician assistants, and certified nurse specialists” Page 315.
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Carol Paton, MSc, PG Cert., CPC, CPMA
Senior Coding Educator
Carol brings over 20 years of industry experience to her role as a Senior Coding Educator at Haugen Consulting Group. With a background in nursing, Carol brings a unique perspective to coding education, allowing her to communicate effectively with both coders and providers to ensure a high-quality learning experience.
A proven self-starter and valuable team member, Carol excels at motivating and developing others while building positive relationships across teams and departments. Her career spans several large specialty health systems, where she has served as a coding auditor and educator, delivering targeted education across various service lines.
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