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    v1.0.28
    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-g2013-extensive-in-home-post-discharge-visit
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    HCPCS G2013: Extensive In-Home Post-Discharge Visit

    Medicare pays $223 on average nationally for this procedure.

    HCPCS Level II code G2013 describes an extensive (75 minutes) in‑home visit for an existing patient following discharge; the service type is a post‑discharge comprehensive home visit and the typical site of service is the beneficiary’s home, domiciliary, rest home, assisted living, or nursing facility furnished within 90 days of an inpatient discharge (limited to no more than nine visits) and used only within a Medicare‑approved CMMI model.

    For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 78-year-old Medicare beneficiary is discharged from an acute care hospital after a 7-day admission for congestive heart failure exacerbation with comorbid chronic obstructive pulmonary disease and stage 3 chronic kidney disease. Within 48 hours of discharge a registered nurse practitioner or physician assistant conducts an extensive in-home post-discharge visit lasting approximately 75 minutes at the patient’s assisted living facility. The visit includes a comprehensive medication reconciliation, review of discharge instructions and follow-up appointments, wound check for a recently placed central line dressing, assessment of vital signs and orthostatic measurements, focused cardiopulmonary and volume-status exam, education of the patient and caregiver on signs of worsening heart failure, coordination with the patient’s primary care physician and home health services, and documentation of barriers to adherence and social needs. Clinical workflow typically involves: pre-visit review of the discharge summary and hospital orders; scheduling within 90 days of inpatient discharge under the Medicare-approved CMMI model; performing the in-home visit with focused assessment, interventions, and documentation; communicating findings to the discharging team and primary care provider; and arranging additional services or urgent follow-up if clinically indicated. Services are limited to beneficiaries’ homes, domiciliary, rest homes, assisted living, or nursing facilities, may be furnished up to nine times within 90 days post-discharge, and apply only within a Medicare-approved CMMI demonstration model.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99497Advance care planning including the explanation and discussion of advance directives, first 30 minutesMay be performed during an in-home post-discharge visit if advance care planning discussion occurs; complements comprehensive discharge care.
    99495Transitional care management services with moderate medical decision complexity, face-to-face visit within 14 days of dischargeOften provided in the post-discharge period; G2013 is a CMMI-model specific in-home visit and may be temporally coordinated with TCM services where allowed.
    99496Transitional care management services with high medical decision complexity, face-to-face visit within 7 days of dischargeUsed for patients requiring higher complexity TCM; may overlap in workflow and communication with the extended in-home visit.
    99324Domiciliary, rest home, or custodial care services, new patient, initial visitRelated site-of-service code used for structured visits in domiciliary settings; illustrates similar service location.
    99327Domiciliary, rest home, or custodial care services, established patient, subsequent visitComparable established-patient visit code for residents in assisted living or nursing facilities during post-discharge follow-up.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    225XM0800XMental Health Occupational TherapistOccupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to en…
    207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianAn orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by part…
    170100000XPh.D. Medical GeneticsA medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to med…

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    A41.9Sepsis, unspecified organism
    B95.61Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere
    E11.9Type 2 diabetes mellitus without complications
    E66.9Obesity, unspecified
    F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F41.1Generalized anxiety disorder
    I21.9Acute myocardial infarction, unspecified
    I50.9Heart failure, unspecified
    I63.9Cerebral infarction, unspecified
    J18.9Pneumonia, unspecified organism

    Showing 1–10 of 28

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01
    Celiac Disease TestingOscar Health2026-10-01
    Laboratory Testing for the Diagnosis of Inflammatory Bowel DiseaseOscar Health2026-10-01
    Percutaneous Electrical Nerve Field Stimulation (PENFS)Cigna2026-09-15
    Colorectal Cancer ScreeningBlue Cross Blue Shield - New Mexico2026-09-04

    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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