G0534 HCPCS Level II Code: Coordinated care/or referral
Medicare Coverage & Payment
- CMS short descriptor: Coordinated care/or referral
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Pricing indicator: 13
- BETOS: M5D — Specialist - other
- Last CMS action effective: January 1, 2025
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 G0534 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)
- G0514 — 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)[Sibling]— CMS HCPCS Level II code set
- G0515 — Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes[Sibling]— CMS HCPCS Level II code set
- G0516 — Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)[Sibling]— CMS HCPCS Level II code set
- G0517 — Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)[Sibling]— CMS HCPCS Level II code set
- G0518 — Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)[Sibling]— CMS HCPCS Level II code set
- G0519 — Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model[Sibling]— CMS HCPCS Level II code set
- G0520 — Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model[Sibling]— CMS HCPCS Level II code set
- G0521 — Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model[Sibling]— CMS HCPCS Level II code set
- and 32 more
Change history
- January 1, 2025 — 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
- January 1, 2025Added to the code setCoordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose or treat an opioid use disorder; each additional 30 minutes of services (provision of the services by a medicare-enrolled opioid treatment program); (list separately in addition to each primary code)
Nearest Codes in This Family
Official HCPCS Level II classifications closest to G0534 in its code family, with their registry titles.
- G0529 — In-home respite care, 4-hour unit, for use in cmmi model
- G0530 — Adult day center, 8-hour unit, for use in cmmi model
- G0531 — Facility-based respite, 24-hour unit, for use in cmmi model
- G0532 — Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in…
- G0533 — Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group…
- G0535 — Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient…
- G0536 — Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud…
- G0537 — Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months
- G0538 — Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month
- G0539 — Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional…