Summary & Overview
HCPCS G0060: Allergy/Immunology MIPS Specialty Set
HCPCS Level II code G0060 identifies the Allergy/Immunology MIPS specialty set, a quality-reporting designation used to categorize performance measures for allergy and immunology clinicians. Nationally, MIPS specialty sets influence clinician performance reporting, public quality profiles, and payment adjustments tied to Medicare and many commercial payers that align with value-based programs. G0060 signals the use of the allergy/immunology measure bundle when reporting clinician performance rather than a procedural claim.
Key payers in use and alignment include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code's purpose, which payers typically recognize the MIPS specialty set, and what the designation implies for clinical quality reporting. The publication reviews benchmark considerations for MIPS reporting, summarizes relevant policy and program changes affecting specialty measures, and provides clinical context to help practices understand where the specialty set applies in outpatient allergy and immunology care.
This summary is intended for a national audience of billing managers, compliance officers, and clinical leaders who need clear, actionable information about the coding and reporting role of HCPCS Level II code G0060.
Billing Code Overview
HCPCS Level II code G0060 represents the Allergy/Immunology MIPS specialty set, a performance measure grouping used in quality reporting for allergy and immunology clinicians. The code denotes the specialty-specific Measures/Instruments set tied to Merit-based Incentive Payment System (MIPS) reporting rather than a discrete clinical procedure.
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Service type: Quality measure set reporting for allergy and immunology
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Typical site of service: Outpatient allergy/immunology clinics and ambulatory care settings
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to an allergy/immunology clinic for evaluation of suspected allergic rhinitis and possible immunotherapy candidacy. The patient presents with seasonal nasal congestion, sneezing, and intermittent wheeze triggered by tree and grass pollen despite use of intranasal corticosteroids and antihistamines. The clinic visit includes focused history, review of prior treatments, performance of skin prick testing or ordering serum specific IgE panels, interpretation of results, and development of an allergy/immunology measurement set entry for MIPS reporting under the specialty set identified by billing code G0060. The clinical workflow: initial nurse intake and vital signs; allergy/immunology clinician documents problem list, performs exam, orders/chooses diagnostic testing (skin testing or serum IgE); documents shared decision-making about immunotherapy vs medical management; if indicated, prepares an immunotherapy plan and documents counseling and consent. Clinical staff complete required documentation and submit quality data elements for the Allergy/Immunology MIPS specialty set using G0060 as the reporting designation for the specialty measure set.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier reported | General reporting when no modifier applies to the service |