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HCPCS G0175 · Level II · G code

G0175: OPPS service,sched team conf, HCPCS Level II G code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file.

Key facts for G0175

Medicare payment
$426.30
OPPS rate, SI V
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Facility outpatient MUE
1
MAI 3
OPPS status
SI V
Clinic or emergency department visit
NCCI PTP pairs
20
11 hospital outpatient
LCDs and articles
0 / 0

TL;DR

CMS describes HCPCS G0175, added in 2000, as "Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present". Hospital outpatient departments are paid $426.30 for G0175 under status indicator V, APC 5024 (Level 4 Type A ED Visits), minimum unadjusted copayment $85.26 (October 2026 Addendum B). CMS caps G0175 at practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. In the NCCI PTP files v323r0 G0175 appears in 2 practitioner pairs as column 2 and 18 as column 1 (most often with 99495, 99496), and in 2 hospital outpatient pairs as column 2 and 9 as column 1. No current LCD or billing article lists G0175; its HCPCS coverage code is C (carrier judgment, so the Medicare contractor decides coverage). HCPCS record: BETOS M6 (consultations); pricing indicator 00; type of service 1 (medical care). Nearby codes: G0176, G0177, G0179, G0180.

G0175 descriptor and code status

The October 2026 HCPCS Level II file describes G0175 as “Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.

HCPCS file attributes of G0175
FieldValue
Short descriptorOpps service,sched team conf
Added to HCPCS2000-07-01
Last actionN (no maintenance), effective 2000-07-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator00: not separately priced by Part B
BETOS categoryM6: consultations
Type of service1: medical care

Medicare payment for G0175

Hospital outpatient departments are paid $426.30 for G0175 under status indicator V, APC 5024 (Level 4 Type A ED Visits), minimum unadjusted copayment $85.26 (October 2026 Addendum B). The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator V (Clinic or emergency department visit), APC 5024 (Level 4 Type A ED Visits), national unadjusted payment $426.30 with a minimum unadjusted copayment of $85.26.

Medically Unlikely Edits for G0175

CMS caps G0175 at practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. The facility outpatient MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for G0175 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction
Facility outpatient hospital13 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction

The MUE lookup for G0175 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0175 is the column-2 (bundled) code in 2 active pairs, 0% of which allow a modifier and the column-1 code in 18 (50% modifier-allowed); 35 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: CPT Manual or CMS manual coding instruction.

Column-1 codes most often paired with G0175 (practitioner)
Column-1 codePairs
99495 (CPT; descriptor licensed by AMA)1
99496 (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into G0175 (practitioner)
Column-2 codePairs
36591 (CPT; descriptor licensed by AMA)1
36592 (CPT; descriptor licensed by AMA)1
90832 (CPT; descriptor licensed by AMA)1
90833 (CPT; descriptor licensed by AMA)1
90834 (CPT; descriptor licensed by AMA)1
90836 (CPT; descriptor licensed by AMA)1
90837 (CPT; descriptor licensed by AMA)1
90838 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, G0175 is the column-2 (bundled) code in 2 active pairs, 100% of which allow a modifier and the column-1 code in 9 (100% modifier-allowed); 35 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: CPT Manual or CMS manual coding instruction.

Column-1 codes most often paired with G0175 (hospital outpatient)
Column-1 codePairs
99495 (CPT; descriptor licensed by AMA)1
99496 (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into G0175 (hospital outpatient)
Column-2 codePairs
90832 (CPT; descriptor licensed by AMA)1
90833 (CPT; descriptor licensed by AMA)1
90834 (CPT; descriptor licensed by AMA)1
90836 (CPT; descriptor licensed by AMA)1
90837 (CPT; descriptor licensed by AMA)1
90838 (CPT; descriptor licensed by AMA)1
90839 (CPT; descriptor licensed by AMA)1
90846 (CPT; descriptor licensed by AMA)1

G0175 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check G0175 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0175

No current LCD or billing and coding article lists G0175. The HCPCS coverage code C means carrier judgment, so the Medicare contractor decides coverage, and any National Coverage Determination for the service still applies.

Denials to expect on G0175

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of G0175 exceed the facility outpatient MUE of 1 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for G0175 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0175 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS G0175

What does HCPCS code G0175 describe?

"Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present" (short descriptor "Opps service,sched team conf"), in the G section (procedures and professional services, temporary). Added 2000-07-01.

Is G0175 a CPT code?

It is not. G0175 belongs to the G section (procedures and professional services, temporary) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for G0175?

Hospital outpatient departments are paid $426.30 for G0175 under status indicator V, APC 5024 (Level 4 Type A ED Visits), minimum unadjusted copayment $85.26 (October 2026 Addendum B).

How many units of G0175 can be billed per day?

CMS caps G0175 at practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. For the facility outpatient MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover G0175?

No current LCD or billing article lists G0175; its HCPCS coverage code is C (carrier judgment, so the Medicare contractor decides coverage).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.