Summary & Overview
HCPCS G0048: Palliative Care During Measurement Period
HCPCS Level II code G0048 denotes the identification of patients who received palliative care at any point from intake through the end of the measurement year. The code is used in quality measurement and reporting to track receipt of palliative care services among populations with serious or life-limiting conditions. Nationally, accurate capture of palliative care encounters supports population-level monitoring of care coordination, symptom management, and alignment of treatment with patient goals. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what HCPCS Level II code G0048 represents clinically and administratively, how it is applied across typical sites of service (inpatient, outpatient, hospice, long-term care, home-based care), and which payers commonly include the measure in reporting or quality frameworks. The publication outlines available benchmarks and policy context where provided and notes when input data are not available. It also covers implications for quality measurement and documentation practices relevant to palliative care delivery and reporting.
Billing Code Overview
HCPCS Level II code G0048 identifies patients who receive palliative care services any time during the intake period through the end of the measurement year. The code captures the occurrence of palliative care during the specified measurement window and is used for reporting care provided to patients with serious, chronic, or life-limiting conditions.
-
Service type: Palliative care services
-
Typical site of service: Palliative care may be delivered in multiple settings, including inpatient hospital units, outpatient clinics, hospice programs, long-term care facilities, and home-based care.
Clinical & Coding Specifications
Clinical Context
A 74-year-old patient with metastatic pancreatic adenocarcinoma is admitted to an inpatient hospice-affiliated palliative medicine service in November. The patient has progressive pain, anorexia, and complex decision-making needs regarding goals of care. During the intake period the interdisciplinary palliative care team — including a palliative medicine physician, nurse practitioner, social worker, and chaplain — performs an initial comprehensive palliative assessment, documents symptom management plans, establishes advance care preferences, and initiates coordination with home hospice and the primary oncology team. The service continues through the end of the measurement year with follow-up symptom management visits, family meetings, and care transitions. Billing is captured using G0048 to indicate that the patient received palliative care services anytime from the intake period through year end.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when services required substantially greater resources or work than typical for palliative care visits (document reason and increased work). |
23 |