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    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-g0299-registered-nurse-home-health-hospice-15-min
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    HCPCS G0299: Direct Skilled Nursing by RN in Home Health/Hospice

    Commercial payers pay $67 on average nationally for this procedure.

    HCPCS Level II code G0299 describes direct skilled nursing services provided by a registered nurse (RN) in the home health or hospice setting, billed in 15-minute increments for hands-on skilled care, observation, and clinical interventions delivered at the patient’s residence or during hospice home visits.

    For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease.

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    National Reimbursement Benchmarks

    National commercial rates for G0299 cluster around BUCA’s average commercial benchmark of $66.9, but substantial payer-level differences are evident. Blue Cross Blue Shield (BCBS) and Cigna sit above BUCA’s average, with Cigna showing a very high centralized rate at $145.3. Aetna and UnitedHealth Group are below BUCA; Aetna’s median of $26 contrasts sharply with BCBS and Cigna. These contrasts create a bimodal landscape: one group near the lower-mid twenties to mid-forties and another at materially higher levels above $60 to $145.

    Rate dispersion (P75 minus P25) highlights variation in contract tightness. Aetna’s P75–P25 is $17.0 ($26.0–$9.0), and UnitedHealth Group’s spread is $22.8 ($55.3–$32.5), indicating relatively tighter distributions. Blue Cross Blue Shield displays the widest interquartile spread at $12.0 ($66.8–$52.8) relative to its scale, while Cigna shows effectively no dispersion (P75–P25 = $0.0), signaling highly uniform contracted rates.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A homebound 78-year-old patient with a history of heart failure (I50.9), chronic obstructive pulmonary disease (J44.9), and type 2 diabetes mellitus (E11.9) is discharged from the hospital after an exacerbation of heart failure and remains bed-confined (Z74.01). The patient receives a hospice/home health referral for skilled nursing visits to monitor cardiopulmonary status, titrate diuretics and inhaled bronchodilator regimens, perform wound checks and focused assessments during aftercare visits (Z48.89), and provide brief caregiver education. A registered nurse (RN) conducts visits in the patient’s home or hospice residence, delivering direct skilled nursing services in 15-minute increments billed under G0299. Typical workflow: pre-visit review of the plan of care and recent hospital records; travel to the home; direct skilled assessment (vitals, lung and edema assessment), medication administration and adjustment per orders, dressing changes or wound assessment if present, documentation in the home health record, communication with the primary care or hospice physician for changes, and updating the plan of care. Encounters are segmented and timed so each 15-minute unit of direct RN skilled care is documented and billed as G0299 when medically necessary and skilled.

    Related CPT Codes

    CPT Code

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    163WH0200XHome Health Registered NurseNursing Service Providers · Registered Nurse
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    251E00000XHome Health AgencyA public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing se…
    246RP1900XPhlebotomy TechnicianTechnologists, Technicians & Other Technical Service Providers · Technician, Pathology
    261QM1200XMagnetic Resonance Imaging (MRI) Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    133VN1201XObesity and Weight Management Nutrition Registered DietitianAn individual who is a Board Certified Specialist for Obesity and Weight Management and educates, supports, and advocates for patients and clients to …
    207WX0110XPediatric Ophthalmology and Strabismus Specialist Physician PhysicianAn ophthalmologist who specializes in pediatric ophthalmology and strabismus management. The subspecialty includes the medical and surgical management…
    207LP3000XPediatric Anesthesiology PhysicianAn anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs…

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01
    Celiac Disease TestingOscar Health2026-10-01
    Laboratory Testing for the Diagnosis of Inflammatory Bowel DiseaseOscar Health2026-10-01
    Percutaneous Electrical Nerve Field Stimulation (PENFS)Cigna2026-09-15
    Colorectal Cancer ScreeningBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    HCPCS-G9490-HOME-ASSESSMENT-NON-HOMEBOUND

    HCPCS G9490: Home Visit Patient Assessment for Non-Homebound Beneficiary

    HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

    HCPCS G0008: Administration of Influenza Virus Vaccine

    HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

    HCPCS G0009: Administration of Pneumococcal Vaccine

    HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

    HCPCS G0010: Administration of Hepatitis B Vaccine

    HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

    HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

    HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

    HCPCS G0012: Injection of PrEP Drug for HIV Prevention

    HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

    HCPCS G0013: Individual PrEP Counseling by Clinical Staff

    HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

    HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

    HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

    HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

    HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

    HCPCS G0019: Community Health Integration, Person-Centered Assessment

    Showing 1–10 of 1996

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Description
    Relationship to This Procedure
    G0300Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutesLPN counterpart to G0299; used when tasks can be delegated to an LPN and billed separately for LPN-skilled time.
    G0162Skilled services by a licensed nurse (RN only) for management and evaluation of the plan of care, each 15 minutesUsed for RN management and evaluation time dedicated to plan-of-care oversight; complements direct care billed with G0299.
    G0493Skilled services of a registered nurse (RN) for the observation and assessment of the patient’s condition, each 15 minutesOverlaps with G0299 for observation/assessment-focused skilled visits; select per payer guidance to avoid duplicate billing.
    G0494Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient’s condition, each 15 minutesLPN observation/assessment equivalent; used when an LPN performs the assessment duties in the home.
    G0495Skilled services of a registered nurse (RN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutesUse when the RN provides formal training/education to patient/family; may be billed in addition to or instead of G0299 depending on payer rules and distinct documentation.
    G0496Skilled services of a licensed practical nurse (LPN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutesUse when LPN provides documented patient/family education and billing rules permit LPN education charges alongside or instead of RN services.