G0012 HCPCS Level II Code: Injection of pre-exposure prophylaxis (prep) drug for HIV prevention, under skin or into muscle
Medicare Coverage & Payment
- CMS short descriptor: Injection of hiv prep drug
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Pricing indicator: 13
- BETOS: P5E — Ambulatory procedures - other
- Last CMS action effective: January 2, 2024
Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.
Contextual Map
Every relationship of G0012 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Nearest codes (40)
- G0008 — Administration of influenza virus vaccine[Sibling]
- G0009 — Administration of pneumococcal vaccine[Sibling]
- G0010 — Administration of hepatitis b vaccine[Sibling]
- G0011 — Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes[Sibling]
- G0013 — Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence[Sibling]
- G0017 — Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes[Sibling]
- G0018 — Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)[Sibling]
- G0019 — Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(s) that are significantly limiting the ability to diagnose or treat problem(s) addressed in an initiating visit: person-centered assessment, performed to better understand the individualized context of the intersection between the sdoh need(s) and the problem(s) addressed in the initiating visit. ++ conducting a person-centered assessment to understand patient's life story, strengths, needs, goals, preferences and desired outcomes, including understanding cultural and linguistic factors and including unmet sdoh needs (that are not separately billed). ++ facilitating patient-driven goal-setting and establishing an action plan. ++ providing tailored support to the patient as needed to accomplish the practitioner's treatment plan. practitioner, home-, and community-based care coordination. ++ coordinating receipt of needed services from healthcare practitioners, providers, and facilities; and from home- and community-based service providers, social service providers, and caregiver (if applicable). ++ communication with practitioners, home- and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ coordination of care transitions between and among health care practitioners and settings, including transitions involving referral to other clinicians; follow-up after an emergency department visit; or follow-up after discharges from hospitals, skilled nursing facilities or other health care facilities. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) to address the sdoh need(s). health education- helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, and preferences, in the context of the sdoh need(s), and educating the patient on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services addressing the sdoh need(s), in ways that are more likely to promote personalized and effective diagnosis or treatment. health care access / health system navigation. ++ helping the patient access healthcare, including identifying appropriate practitioners or providers for clinical care and helping secure appointments with them. facilitating behavioral change as necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach person-centered diagnosis or treatment goals. facilitating and providing social and emotional support to help the patient cope with the problem(s) addressed in the initiating visit, the sdoh need(s), and adjust daily routines to better meet diagnosis and treatment goals. leveraging lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals[Sibling]
- and 32 more
Change history
- January 2, 2024 — Added to the code set [Change history]
Sources for this page
Every coding fact on this page is read from the datasets below. Nothing is AI-generated; MedCoder-derived relationships and editorial are labelled where they appear.
- Code, descriptors, coverage and pricing attributes
- CMS HCPCS Alpha-Numeric (ANWEB) release — July 2026 quarterly update
- Change history and date-of-service validity
- CMS HCPCS quarterly update files, ingested into the change ledger
- Comparisons, relationships and the contextual map MedCoder-derived
- Derived by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Change history
- January 2, 2024Added to the code setInjection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle
Nearest Codes in This Family
Official HCPCS Level II classifications closest to G0012 in its code family, with their registry titles.
- G0008 — Administration of influenza virus vaccine
- G0009 — Administration of pneumococcal vaccine
- G0010 — Administration of hepatitis b vaccine
- G0011 — Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial…
- G0013 — Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv…
- G0017 — Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting);…
- G0018 — Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting);…
- G0019 — Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes…
- G0022 — Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)
- G0023 — Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar…