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HCPCS G0514 · Level II · G code

G0514: Prolonged preventive service(s) (beyond the typical service time of the primary procedure), 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 G0514

Medicare payment
$64.80
PFS non-facility, national; facility $50.77
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
1
MAI 1
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0
on the Medicare telehealth list

TL;DR

CMS describes HCPCS G0514, added in 2018, as "Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)". National PFS payment for G0514 is $64.80 in an office and $50.77 in a facility (October 2026), built from 1.17 work, 0.70 practice-expense and 0.07 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $65.12 at $33.5675. Global period ZZZ (add-on service inside the primary service's global period). CMS caps G0514 at practitioner 1 (MAI 1, Clinical: CMS Workgroup); hospital outpatient 1 (MAI 1, Clinical: CMS Workgroup) units per day in the 2026 Q4 MUE tables. G0514 is an add-on code (NCCI edit type 1): Medicare pays it only on a claim that also carries one of 1 primary code such as G0513. G0514 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 N: Items and Services packaged into APC rates. HCPCS record: BETOS M5D (specialist - other); pricing indicator 13; type of service 1 (medical care). 1 other active code opens with "Prolonged preventive service"; related codes: G0513, G0516, G0508, G0506.

G0514 descriptor and code status

The October 2026 HCPCS Level II file describes G0514 as “Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.

HCPCS file attributes of G0514
FieldValue
Short descriptorProlong prev svcs, addl 30m
Added to HCPCS2018-01-01
Last actionN (no maintenance), effective 2018-01-01
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 G0514

National PFS payment for G0514 is $64.80 in an office and $50.77 in a facility (October 2026), built from 1.17 work, 0.70 practice-expense and 0.07 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $65.12 at $33.5675. Global period ZZZ (add-on service inside the primary service's global period). 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 ZZZ (add-on service inside the primary service's global period); PC/TC indicator 0 (physician service; the professional/technical split does not apply).

PFS relative values and national payment for G0514
ComponentNon-facilityFacility
Work RVU1.171.17
Practice expense RVU0.700.28
Malpractice RVU0.070.07
Total RVUs1.941.52
National payment (CF $33.4009)$64.80$50.77
Qualifying APM participant (CF $33.5675)$65.12$51.02
  • 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 N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Medically Unlikely Edits for G0514

CMS caps G0514 at practitioner 1 (MAI 1, Clinical: CMS Workgroup); hospital outpatient 1 (MAI 1, Clinical: CMS Workgroup) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a claim-line edit: units above the limit deny on that line, and separately documented services can go on another line with an appropriate modifier.

MUE values for G0514 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services11 Line EditClinical: CMS Workgroup
Facility outpatient hospital11 Line EditClinical: CMS Workgroup

The MUE lookup for G0514 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists G0514 in v323r0.

G0514 is an add-on code: it is payable only with a primary service on the same claim (G0513). CPT primary codes are shown as numbers only.

Pair counts show exposure, not the answer for one claim. Check G0514 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0514

No current LCD or billing and coding article lists G0514. 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

G0514 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 G0514

CARC 50 · N115

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

CARC 151 · N362

units of G0514 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 G0514 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0514 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 G0514

What does HCPCS code G0514 describe?

"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)" (short descriptor "Prolong prev svcs, addl 30m"), in the G section (procedures and professional services, temporary). Added 2018-01-01.

Is G0514 a CPT code?

It is not. G0514 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 G0514?

National PFS payment for G0514 is $64.80 in an office and $50.77 in a facility (October 2026), built from 1.17 work, 0.70 practice-expense and 0.07 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $65.12 at $33.5675. Global period ZZZ (add-on service inside the primary service's global period).

Is G0514 an add-on code?

G0514 is an add-on code (NCCI edit type 1): Medicare pays it only on a claim that also carries one of 1 primary code such as G0513.

How many units of G0514 can be billed per day?

CMS caps G0514 at practitioner 1 (MAI 1, Clinical: CMS Workgroup); hospital outpatient 1 (MAI 1, Clinical: CMS Workgroup) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 1), units above 1 on one line deny, and a separately documented service can go on its own line with a modifier; denials arrive as CARC 151.

Does Medicare cover G0514?

G0514 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 G0514 be billed as telehealth?

Yes. G0514 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.