G0521 HCPCS Level II Code: Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model
Medicare Coverage & Payment
- CMS short descriptor: New pt-cg dyad dem hig cmplx
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Pricing indicator: 13
- BETOS: Z2 — Undefined codes
- Last CMS action effective: July 1, 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 G0521 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)
- G0500 — Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)[Sibling]— CMS HCPCS Level II code set
- G0501 — Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)[Sibling]— CMS HCPCS Level II code set
- G0502 — Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies[Sibling]— CMS HCPCS Level II code set
- G0503 — Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment[Sibling]— CMS HCPCS Level II code set
- G0504 — Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)[Sibling]— CMS HCPCS Level II code set
- G0505 — Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home[Sibling]— CMS HCPCS Level II code set
- G0506 — Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)[Sibling]— CMS HCPCS Level II code set
- G0507 — Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team[Sibling]— CMS HCPCS Level II code set
- and 32 more
Change history
- July 1, 2024 — Added to the code set [Change history]— CMS release files (code change ledger)
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, descriptors, coverage and pricing attributes Official source data
- CMS HCPCS Alpha-Numeric (ANWEB) release — July 2026 quarterly update Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS HCPCS quarterly update files, ingested into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Change history
- July 1, 2024Added to the code setManagement of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model
Nearest Codes in This Family
Official HCPCS Level II classifications closest to G0521 in its code family, with their registry titles.
- G0516 — Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
- G0517 — Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
- G0518 — Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
- G0519 — Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model
- G0520 — Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
- G0522 — Management of a new patient with dementia, low complexity, for use in cmmi model
- G0523 — Management of a new patient with dementia, moderate to high complexity, for use in cmmi model
- G0524 — Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model
- G0525 — Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
- G0526 — Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model