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    v1.0.31
    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-g0406-follow-up-inpatient-telehealth-limited-15-min
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    HCPCS G0406: Follow-up Inpatient Consultation, Limited

    Medicare pays $37 on average nationally for this procedure.

    HCPCS Level II code G0406 describes a follow-up inpatient consultation, limited, for which physicians typically spend about 15 minutes communicating with the patient via telehealth; the service type is follow-up consultation (limited) and the typical site of service is inpatient delivered through a telemedicine/telehealth visit.

    For related coverage guidance, see recent payer policy updates: Achalasia and Gastroesophageal Reflux Disease (GERD) - Minimally Invasive Procedures - Medical Policy, Esophageal Brush Biopsy, Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A hospitalized patient with an acute medical condition (for example, acute decompensated heart failure or community-acquired pneumonia) requires a specialty follow-up assessment after an initial inpatient consult. The patient is in a hospital room and the consultant physician connects by telehealth to the patient and the primary inpatient team. The physician spends approximately 15 minutes performing a focused history review, reviewing recent labs and imaging, confirming response to initial treatment, and communicating recommendations to the patient and inpatient team. Documentation includes reason for consult, focused exam findings or virtual inspection, assessment, and specific plan or changes in management. The encounter is billed as a limited follow-up inpatient consultation under G0406 with applicable place-of-service and telehealth modifiers when required. Typical workflow: the inpatient team places the consult request, the consultant reviews chart and relevant data, schedules a brief telehealth session, completes documentation in the medical record, and communicates recommendations to the primary team and the patient or their surrogate.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99231Subsequent hospital care, per day, for the evaluation and management of a patient, typically 15 minutesOften billed by the primary inpatient physician for daily follow-up care; parallels the time and focus of a limited follow-up consultation
    99232Subsequent hospital care, per day, typically 25 minutesUsed when a more detailed follow-up visit is provided in person and more time is spent than a G0406 telehealth limited consult
    99446Interprofessional telephone/Internet assessment and management service provided by a consultative physician, 5-10 minutesUsed when consultative advice is provided remotely to the requesting provider; may accompany or precede a formal inpatient consult
    99452Interprofessional telephone/Internet/electronic health record referral service provided by a treating/requesting physician, 30 minutesDocuments time the requesting clinician spends coordinating the referral; related to workflow but not a substitute for G0406
    G0407Follow-up inpatient consultation, expanded, physicians typically spend 25 minutes communicating with the patient via telehealthAn alternative G-code for a longer telehealth follow-up consultation when more time and complexity are required

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207QA0000X
    207ZP0105X
    207WX0107X
    247000000X
    225400000X
    207RI0011X
    3336C0002X
    363LP0222X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    A41.9Sepsis, unspecified organism
    B34.9Viral infection, unspecified
    E11.9Type 2 diabetes mellitus without complications
    E66.9Obesity, unspecified
    E78.5Hyperlipidemia, unspecified
    F32.9Major depressive disorder, single episode, unspecified
    F41.9Anxiety disorder, unspecified
    G43.909Migraine, unspecified, not intractable, without status migrainosus
    I21.3ST elevation (STEMI) myocardial infarction of unspecified site
    I50.9Heart failure, unspecified

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Achalasia and Gastroesophageal Reflux Disease (GERD) - Minimally Invasive Procedures - Medical PolicyHealth-New-England2027-02-01
    Esophageal Brush Biopsycaresourcegeorgia2026-12-01
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Gastric Pacing/Gastric Electrical Stimulation (GES)Cigna2026-11-15
    Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interactionpremerabluecrossofwashington2026-11-06
    Percutaneous electrical nerve field stimulation for disorders of gut-brain interactionpremerabluecrossofwashington2026-11-06
    Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interactionpremerabluecrossofwashington2026-11-06
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Non-invasive Testing for Liver FibrosisModa Health2026-11-01
    Surgical Site of Care - Colonoscopy and Sigmoidoscopyregence2026-11-01

    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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