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HCPCS G0299: Registered Nurse Skilled Nursing in Home Health or Hospice

HCPCS Level II code G0299 designates direct, time-based skilled nursing by a registered nurse in the home health or hospice setting, billed in 15-minute units. This code captures hands-on clinical activities such as skilled assessment, complex wound care, medication administration, and other interventions that require an RN in the patient’s home or hospice residence. Nationally, accurate use of G0299 matters for documenting clinical acuity, ensuring appropriate claims processing, and distinguishing RN-level skilled care from LPN services.

The analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage considerations, relevant clinical contexts where G0299 is typically billed, comparisons to related HCPCS services, and notes on encounter-level documentation needed to support time-based skilled nursing claims. The publication also summarizes common clinical diagnoses that often accompany RN home health or hospice nursing, and highlights coding relationships to other time-based nursing and home-health HCPCS codes.

This summary is written for a national audience of clinicians, billing professionals, and policy analysts seeking a concise reference on the clinical and billing role of G0299 in home health and hospice service lines.

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Billing Code Overview

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. This service type covers hands-on, clinically necessary nursing care delivered at the patient’s residence or in a hospice environment. Typical site of service is home health or hospice (patient’s home or residence-based hospice care).

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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HCPCS G0299: Registered Nurse Skilled Nursing in Home Health or Hospice

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Billing Code Overview

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

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.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same provider on the same day	Use when an RN documents a distinct, separately reportable skilled assessment or visit in addition to another procedure or service on the same day.
`26`	Professional component	Use when billing requires separation of professional component for services that include both professional and technical components (rare for home RN visits).
`52`	Reduced services	Use when the RN provides reduced skilled service relative to normal expectations but still documents medical necessity for partial service.
`53`	Discontinued procedure	Use when an RN visit is started but discontinued due to patient condition or safety concerns and documentation supports discontinuation.
`56`	Preoperative management only	Use when the RN provides only preoperative skilled management when applicable to home pre-op education or assessment for an upcoming procedure.
`62`	Two surgeons	Use when two qualified RNs/clinicians provide separate skilled services requiring dual billing considerations (infrequent; follow payer rules).
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Rarely applicable; used only if a related skilled nursing procedural return situation meets payer criteria.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when the RN provides direct skilled assessment via live audiovisual telehealth and payer allows modifier `95` with `G0299`.
`G0`	Temporary COVID-19 policy - telehealth disallowed modifier (CMS-specific)	Use per payer guidance when a public health emergency policy requires `G0` for certain telehealth visits delivered during COVID-19 exceptions.
`QK`	Medical direction of two or more qualified health care professionals by a physician or other qualified provider	Use in team-based care arrangements where medical direction rules apply to home health RN supervisory billing.
`QX`	CRNA service with medical direction by a physician	Generally not applicable to home RN visits; include only when billing rules for supervised services require distinct identification.
`QY`	Medical direction of one qualified health care professional by a physician	Use when physician direction of the RN visit meets payer criteria for medical direction modifiers.
`TF`	Telehealth modifier for distant site used prior to `95` adoption	Use when payer requires `TF` instead of `95` to indicate telehealth distant site services.

Taxonomy Code	Specialty	Notes
`163WH0200X`	Home Health Registered Nurse	Primary provider taxonomy for RNs delivering skilled home health nursing services billed with `G0299`.
`163W00000X`	Registered Nurse	General RN taxonomy; applicable when RN services occur outside a specific home health agency taxonomy.
`251E00000X`	Home Health Agency	Organizational taxonomy for the agency billing or coordinating the RN home visits.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z74.01`	Bed confinement status	Indicates patient is homebound/bed-confined and may require skilled home nursing visits for monitoring and care, supporting medical necessity for `G0299`.
`Z48.89`	Encounter for other specified aftercare	Represents post-procedural or post-discharge skilled follow-up care in the home, often requiring RN skilled services billed with `G0299`.
`I50.9`	Heart failure, unspecified	Patients with heart failure frequently require home RN skilled assessment, medication titration, and monitoring, appropriate for `G0299` billing.
`J44.9`	Chronic obstructive pulmonary disease, unspecified	COPD exacerbations and chronic management necessitate skilled respiratory assessment and interventions by an RN in the home.
`E11.9`	Type 2 diabetes mellitus without complications	Diabetes management, wound assessment, and medication administration by an RN in the home are common reasons to bill `G0299`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`G0300`	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	LPN counterpart to `G0299`; used when tasks can be delegated to an LPN and billed separately for LPN-skilled time.
`G0162`	Skilled services by a licensed nurse (RN only) for management and evaluation of the plan of care, each 15 minutes	Used for RN management and evaluation time dedicated to plan-of-care oversight; complements direct care billed with `G0299`.
`G0493`	Skilled services of a registered nurse (RN) for the observation and assessment of the patient’s condition, each 15 minutes	Overlaps with `G0299` for observation/assessment-focused skilled visits; select per payer guidance to avoid duplicate billing.
`G0494`	Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient’s condition, each 15 minutes	LPN observation/assessment equivalent; used when an LPN performs the assessment duties in the home.
`G0495`	Skilled 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 minutes	Use 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.
`G0496`	Skilled 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 minutes	Use when LPN provides documented patient/family education and billing rules permit LPN education charges alongside or instead of RN services.

HCPCS G9490: Home Visit Assessment for Non-Homebound Patients

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Influenza Virus Vaccine Administration

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 Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

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

HCPCS G0013: Individual PrEP Counseling and HIV Risk Assessment

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 for Social Determinants of Health

Showing 1–10 of 1996

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same provider on the same day	Use when an RN documents a distinct, separately reportable skilled assessment or visit in addition to another procedure or service on the same day.
`26`	Professional component	Use when billing requires separation of professional component for services that include both professional and technical components (rare for home RN visits).
`52`	Reduced services	Use when the RN provides reduced skilled service relative to normal expectations but still documents medical necessity for partial service.
`53`	Discontinued procedure	Use when an RN visit is started but discontinued due to patient condition or safety concerns and documentation supports discontinuation.
`56`	Preoperative management only	Use when the RN provides only preoperative skilled management when applicable to home pre-op education or assessment for an upcoming procedure.
`62`	Two surgeons	Use when two qualified RNs/clinicians provide separate skilled services requiring dual billing considerations (infrequent; follow payer rules).
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Rarely applicable; used only if a related skilled nursing procedural return situation meets payer criteria.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use when the RN provides direct skilled assessment via live audiovisual telehealth and payer allows modifier `95` with `G0299`.
`G0`	Temporary COVID-19 policy - telehealth disallowed modifier (CMS-specific)	Use per payer guidance when a public health emergency policy requires `G0` for certain telehealth visits delivered during COVID-19 exceptions.
`QK`	Medical direction of two or more qualified health care professionals by a physician or other qualified provider	Use in team-based care arrangements where medical direction rules apply to home health RN supervisory billing.
`QX`	CRNA service with medical direction by a physician	Generally not applicable to home RN visits; include only when billing rules for supervised services require distinct identification.
`QY`	Medical direction of one qualified health care professional by a physician	Use when physician direction of the RN visit meets payer criteria for medical direction modifiers.
`TF`	Telehealth modifier for distant site used prior to `95` adoption	Use when payer requires `TF` instead of `95` to indicate telehealth distant site services.

Taxonomy Code	Specialty	Notes
`163WH0200X`	Home Health Registered Nurse	Primary provider taxonomy for RNs delivering skilled home health nursing services billed with `G0299`.
`163W00000X`	Registered Nurse	General RN taxonomy; applicable when RN services occur outside a specific home health agency taxonomy.
`251E00000X`	Home Health Agency	Organizational taxonomy for the agency billing or coordinating the RN home visits.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z74.01`	Bed confinement status	Indicates patient is homebound/bed-confined and may require skilled home nursing visits for monitoring and care, supporting medical necessity for `G0299`.
`Z48.89`	Encounter for other specified aftercare	Represents post-procedural or post-discharge skilled follow-up care in the home, often requiring RN skilled services billed with `G0299`.
`I50.9`	Heart failure, unspecified	Patients with heart failure frequently require home RN skilled assessment, medication titration, and monitoring, appropriate for `G0299` billing.
`J44.9`	Chronic obstructive pulmonary disease, unspecified	COPD exacerbations and chronic management necessitate skilled respiratory assessment and interventions by an RN in the home.
`E11.9`	Type 2 diabetes mellitus without complications	Diabetes management, wound assessment, and medication administration by an RN in the home are common reasons to bill `G0299`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`G0300`	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	LPN counterpart to `G0299`; used when tasks can be delegated to an LPN and billed separately for LPN-skilled time.
`G0162`	Skilled services by a licensed nurse (RN only) for management and evaluation of the plan of care, each 15 minutes	Used for RN management and evaluation time dedicated to plan-of-care oversight; complements direct care billed with `G0299`.
`G0493`	Skilled services of a registered nurse (RN) for the observation and assessment of the patient’s condition, each 15 minutes	Overlaps with `G0299` for observation/assessment-focused skilled visits; select per payer guidance to avoid duplicate billing.
`G0494`	Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient’s condition, each 15 minutes	LPN observation/assessment equivalent; used when an LPN performs the assessment duties in the home.
`G0495`	Skilled 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 minutes	Use 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.
`G0496`	Skilled 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 minutes	Use when LPN provides documented patient/family education and billing rules permit LPN education charges alongside or instead of RN services.

HCPCS G9490: Home Visit Assessment for Non-Homebound Patients

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Influenza Virus Vaccine Administration

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 Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

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

HCPCS G0013: Individual PrEP Counseling and HIV Risk Assessment

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 for Social Determinants of Health

Showing 1–10 of 1996

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS G0299: Registered Nurse Skilled Nursing in Home Health or Hospice

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Billing Code Overview

National Reimbursement Benchmarks

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HCPCS G0299: Registered Nurse Skilled Nursing in Home Health or Hospice

Sign up for hcpcs G0299 policy alerts

Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References