Chronic Pain Specialists:  New Medicare "G" Codes G3002 & G3003: Essential Information for Providers

At MD Labs, we're committed to keeping our referring providers informed about important changes that may impact patient care. Recently, Medicare introduced two new HCPCS codes, G3002 and G3003, specifically designed to bundle services during chronic pain management encounters.  Here’s what you need to know about these updates and how they may relate to your practice.

 

Overview of these "G" Codes

G3002: This code is intended for a bundled 30-minute session per calendar month that covers various aspects of chronic pain management. The services included under G3002 are:

  1. Diagnosis, assessment, and monitoring of chronic pain

  2. Use of a validated pain rating scale or tool

  3. Development and maintenance of a patient-centered care plan

  4. Medication management and counseling on pain literacy

  5. Coordination of necessary behavioral health treatment

  6. Ongoing communication and coordination with other relevant practitioners

 

G3003: This code allows for billing additional 15-minute increments beyond the initial 30 minutes covered by G3002.

 

Key Points for Providers

  1. Comprehensive Care Bundle: The G3002 code consolidates multiple chronic pain management services into a single billing option.

  2. Additional Time Billing: The G3003 code provides a mechanism for billing additional time spent on chronic pain management, in 15-minute increments.

  3. Documentation Requirements: Providers should ensure comprehensive documentation of all services covered under G3002 and any additional time billed under G3003 to meet Medicare’s billing standards.

 

Considerations

  1. Billing Practices: These codes may require updates to your practice’s billing procedures to ensure compliance and accurate reimbursement.

  2. EHR Updates: It may be necessary to update your electronic health record (EHR) system to capture the specific documentation required for these codes.

 

For more detailed information or assistance with implementation, referring providers may consult relevant Medicare resources or contact their billing support teams.

 

For more information, see:  

https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-08-22-mlnc

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