With the new year comes new G codes, and ConfirmaMD’s Billing/Coding Supervisor Joy Baker is here to break them down. Joy and her team work with every ConfirmaMD client account daily to review, bill, or code out their charges. She also provides clients with constant feedback on billing, insurance, or documentation issues. Now she tells us what you need to know about two new codes that became effective on January 1, 2023: G3002 and G3003.

First, here are the details of each code.

• G3002: Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g., physical therapy and occupational therapy, and community-based care, as appropriate. Required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (When using G3002, 30 minutes must be met or exceeded.)
• G3003: Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional per calendar month. (List separately in addition to code for G3002. When using G3003, 15 minutes must be met or exceeded.)

So, what does this mean for the chronic pain industry? The two codes will help improve pain care for Americans over 65 or disabled by paying separately for physicians to spend more time with chronic care patients creating and modifying treatment plans and coordinating team-based comprehensive chronic pain care.

Like everything, there are positives and negatives. On the positive side, all visits after the initial face-to-face visit can be furnished via telehealth (according to the telehealth policies). As well, coverage of these services reflects CMS’s interest in improving the care experience for those with chronic pain and more appropriately reflects the time and resources involved in providing comprehensive CPM services. However, on the negative side, all time calculated must be by the physician or other qualified health professional, and any clinical staff time cannot be included.

Need to Know? Two new G codes will now impact the chronic pain industry by improving pain care for Americans over 65 or disabled. ConfirmaMD’s team of billing experts can help you with any questions you have. Schedule a quick call or reach us online at www.ConfirmaMD.com