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HCPCS G0439 · Level II · G code

G0439: Annual wellness visit, includes a personalized prevention plan of service (PPS), 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 G0439

Medicare payment
$137.61
PFS non-facility, national
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
1
MAI 2
OPPS status
SI A
Services not paid under OPPS; paid under fee schedule or other payment system
NCCI PTP pairs
94
84 hospital outpatient
LCDs and articles
0 / 0
on the Medicare telehealth list

TL;DR

CMS describes HCPCS G0439, added in 2011, as "Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit". National PFS payment for G0439 is $137.61 in an office and no facility amount in a facility (October 2026), built from 1.92 work, 2.07 practice-expense and 0.13 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $138.30 at $33.5675. CMS caps G0439 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. G0439 is a primary code for 2 add-on codes (G0506, G0513). In the NCCI PTP files v323r0 G0439 appears in 3 practitioner pairs as column 2 and 91 as column 1 (most often with 99483, G0402, G0438), and in 3 hospital outpatient pairs as column 2 and 81 as column 1. G0439 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code C (carrier judgment, so the Medicare contractor decides coverage) and any NCD. It is on the CY2026 Medicare telehealth list (CMS action: Maintain). OPPS status indicator A: Services not paid under OPPS; paid under fee schedule or other payment system. HCPCS record: BETOS M5D (specialist - other); pricing indicator 13; type of service 1 (medical care). 1 other active code opens with "Annual wellness visit"; related codes: G0438, G0442, G0443, G0444.

G0439 descriptor and code status

The October 2026 HCPCS Level II file describes G0439 as “Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G0439 CPT code", G0439 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of G0439
FieldValue
Short descriptorPpps, subseq visit
Added to HCPCS2011-01-01
Last actionN (no maintenance), effective 2011-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator13: physician fee schedule, priced by the contractor
BETOS categoryM5D: specialist - other
Type of service1: medical care

Medicare payment for G0439

National PFS payment for G0439 is $137.61 in an office and no facility amount in a facility (October 2026), built from 1.92 work, 2.07 practice-expense and 0.13 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $138.30 at $33.5675. 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 A: active: paid separately under the physician fee schedule when covered. Global period XXX (global surgery concept does not apply); PC/TC indicator 0 (physician service; the professional/technical split does not apply).

PFS relative values and national payment for G0439
ComponentNon-facilityFacility
Work RVU1.921.92
Practice expense RVU2.07NA
Malpractice RVU0.130.13
Total RVUs4.12NA
National payment (CF $33.4009)$137.61n/a
Qualifying APM participant (CF $33.5675)$138.30n/a
  • Multiple procedures (modifier 51): no multiple-procedure reduction
  • Bilateral (modifier 50): 150% bilateral adjustment does not apply
  • Assistant at surgery: assistant at surgery paid only with documentation; co-surgeons: co-surgeons not permitted; team surgery: team surgeons not permitted
  • Physician supervision of diagnostic procedures: supervision concept does not apply

Hospital outpatient (OPPS Addendum B)

Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.

Medically Unlikely Edits for G0439

CMS caps G0439 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.

MUE values for G0439 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction
Facility outpatient hospital12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction

The MUE lookup for G0439 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0439 is the column-2 (bundled) code in 3 active pairs, 33% of which allow a modifier and the column-1 code in 91 (76% modifier-allowed); 164 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.

Column-1 codes most often paired with G0439 (practitioner)
Column-1 codePairs
99483 (CPT; descriptor licensed by AMA)1
G0402 Initial preventive exam1
G0438 Ppps, initial visit1
Column-2 codes bundled into G0439 (practitioner)
Column-2 codePairs
36591 (CPT; descriptor licensed by AMA)1
36592 (CPT; descriptor licensed by AMA)1
90791 (CPT; descriptor licensed by AMA)1
90792 (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

In the hospital outpatient PTP file v323r0, G0439 is the column-2 (bundled) code in 3 active pairs, 33% of which allow a modifier and the column-1 code in 81 (85% modifier-allowed); 155 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.

Column-1 codes most often paired with G0439 (hospital outpatient)
Column-1 codePairs
99483 (CPT; descriptor licensed by AMA)1
G0402 Initial preventive exam1
G0438 Ppps, initial visit1
Column-2 codes bundled into G0439 (hospital outpatient)
Column-2 codePairs
90791 (CPT; descriptor licensed by AMA)1
90792 (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

G0439 is a designated primary code for 2 add-on codes (G0506, G0513).

Pair counts show exposure, not the answer for one claim. Check G0439 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0439

No current LCD or billing and coding article lists G0439. The HCPCS coverage code C means carrier judgment, so the Medicare contractor decides coverage, and any National Coverage Determination for the service still applies.

Telehealth status

G0439 is on the CY2026 Medicare telehealth services list (CMS action: Maintain). Bill it with the place-of-service code and modifiers that match where the patient and the practitioner are on the date of service.

Denials to expect on G0439

CARC 50 · N115

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

CARC 151 · N362

units of G0439 exceed the practitioner MUE of 1 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for G0439 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0439 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 G0439

What does HCPCS code G0439 describe?

"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit" (short descriptor "Ppps, subseq visit"), in the G section (procedures and professional services, temporary). Added 2011-01-01.

Is G0439 a CPT code?

It is not. G0439 belongs to the G section (procedures and professional services, temporary) of HCPCS Level II, the CMS code set, not to AMA CPT. "G0439 CPT code" searches refer to it.

What does Medicare pay for G0439?

National PFS payment for G0439 is $137.61 in an office and no facility amount in a facility (October 2026), built from 1.92 work, 2.07 practice-expense and 0.13 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $138.30 at $33.5675.

Is G0439 an add-on code?

G0439 is a primary code for 2 add-on codes (G0506, G0513).

How many units of G0439 can be billed per day?

CMS caps G0439 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 2), units above 1 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover G0439?

G0439 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code C (carrier judgment, so the Medicare contractor decides coverage) and any NCD.

Can G0439 be billed as telehealth?

Yes. G0439 is on the CY2026 Medicare telehealth list (Maintain); the place-of-service and modifier rules on the date of service still apply.

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.