Key facts for G0544
- Medicare payment
- $66.80
- PFS non-facility, national; facility $43.09
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- Practitioner MUE
- 1
- MAI 2
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 0 / 0
TL;DR
HCPCS Level II G0544 reads "Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month" in the October 2026 file; it dates from 2025. National PFS payment for G0544 is $66.80 in an office and $43.09 in a facility (October 2026), built from 0.98 work, 0.95 practice-expense and 0.07 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $67.14 at $33.5675. CMS caps G0544 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. No current LCD or billing article lists G0544; its HCPCS coverage code is C (carrier judgment, so the Medicare contractor decides coverage). HCPCS record: BETOS M5D (specialist - other); pricing indicator 13; type of service 1 (medical care). Nearby codes: G0545, G0542, G0541, G0539.
G0544 descriptor and code status
The October 2026 HCPCS Level II file describes G0544 as “Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.
| Field | Value |
|---|---|
| Short descriptor | Post d/c phone follow up |
| Added to HCPCS | 2025-01-01 |
| Last action | N (no maintenance), effective 2025-01-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 13: physician fee schedule, priced by the contractor |
| BETOS category | M5D: specialist - other |
| Type of service | 1: medical care |
Medicare payment for G0544
National PFS payment for G0544 is $66.80 in an office and $43.09 in a facility (October 2026), built from 0.98 work, 0.95 practice-expense and 0.07 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $67.14 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).
| Component | Non-facility | Facility |
|---|---|---|
| Work RVU | 0.98 | 0.98 |
| Practice expense RVU | 0.95 | 0.24 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVUs | 2.00 | 1.29 |
| National payment (CF $33.4009) | $66.80 | $43.09 |
| Qualifying APM participant (CF $33.5675) | $67.14 | $43.30 |
- 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 S (Procedure or service, not discounted when multiple), APC 5822 (Level 2 Health and Behavior Services), national unadjusted payment $103.79 with a minimum unadjusted copayment of $20.76.
Medically Unlikely Edits for G0544
CMS caps G0544 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.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 1 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
| Facility outpatient hospital | 1 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
The MUE lookup for G0544 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists G0544 in v323r0.
G0544 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 G0544 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for G0544
No current LCD or billing and coding article lists G0544. 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 G0544
the modifier reported is inconsistent with the code
the claim lacks the description, invoice or pricing detail a contractor-priced code needs
Where QuickIntell fits for G0544 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0544 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS G0544
What does HCPCS code G0544 describe?
"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month" (short descriptor "Post d/c phone follow up"), in the G section (procedures and professional services, temporary). Added 2025-01-01.
Is G0544 a CPT code?
It is not. G0544 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 G0544?
National PFS payment for G0544 is $66.80 in an office and $43.09 in a facility (October 2026), built from 0.98 work, 0.95 practice-expense and 0.07 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $67.14 at $33.5675.
How many units of G0544 can be billed per day?
CMS caps G0544 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 G0544?
No current LCD or billing article lists G0544; its HCPCS coverage code is C (carrier judgment, so the Medicare contractor decides coverage).
CMS guidance
The Medicare Learning Network publication that CMS issues on this topic, cited by ICN and publication date:
- Behavioral Health Integration Services(MLN909432, )Behavioral health integration and collaborative care: team members, consent and the billing codes.
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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
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.