Below is a news release from Priority Health:
On Jan. 1, 2023, CMS released two new care management codes for chronic pain management – G3002 and G3003 – which allow providers helping chronic pain patients to bundle key services and bill monthly rather than a’ la carte.
Effective Jan. 1, 2023, Priority health is covering these codes for our commercial, individual / ACA and Medicare plans, including D-SNP.
What do these codes cover?
Any provider helping a Priority Health member manage their chronic pain through the services listed below may use these codes.
G3002: Chronic pain management and treatment, monthly bundle including:
- Diagnosis
- Assessment and monitoring
- Administration of a validated pain rating scale or tool
- Development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes
- Overall treatment management
- Facilitation and coordination of any necessary behavioral health treatment
- Medication management
- Pain and health literacy counseling
- Any necessary chronic pain related crisis care
- Ongoing communication and care coordination between relevant practitioners furnishing care e.g., physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate
Requires initial visit at least 30 minutes in length provided by a physician or other health care professional able bill Priority Health, per calendar month. When using G3002, 30 minutes must be met or exceeded.
G3003: Each additional 15 minutes of chronic pain management and treatment by a physician or health care professional able bill Priority Health, per calendar month. List separately in addition to code for G3002. When using G3003, 15 minutes must be met or exceeded.
Additional details
Below are a few important billing details related to these new codes; find more information in our G3002 / G3003 FAQ.
- Both codes can be billed virtually
- G3002 can be billed once per calendar month
- G3003 can be billed as many times per calendar month as medically necessary once G3002 is billed
- Both codes can be billed with other codes, including procedure codes, E/M codes and other care management codes