HCPCS Level II code G0013 represents individual counseling by clinical staff for pre-exposure prophylaxis (PrEP) aimed at preventing human immunodeficiency virus (HIV). The code covers HIV risk assessment (initial and ongoing), targeted risk-reduction counseling, and medication adherence support—services that are central to HIV prevention efforts and to maximizing the effectiveness of PrEP at the population level. National attention on PrEP uptake and retention makes billing clarity for these counseling services important for clinics and payers.

Key payers in the analysis include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical service represented by G0013, an overview of typical care settings, and the common modifiers associated with billing this service. The publication summarizes payer coverage patterns and benchmarking context where available and highlights policy and coding considerations that affect reimbursement and program implementation. The content provides clinicians, billing staff, and policy analysts with the operational context needed to identify when G0013 applies, how it aligns with preventive care for HIV, and what documentation elements are commonly relevant. Data not available in the input will be noted as such in the detailed sections.