G0011 HCPCS Level II code: Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus…
G0011 is the HCPCS code for “Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment…” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G0011Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes
Short description: Hiv prep counsel, md 15-30m
HCPCS · United States
Medicare details
The indicators CMS publishes with G0011 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Physician fee schedule – Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)
- Type of service
- Medical care
- BETOS category
- Ambulatory procedures - other
- Added
- Jan 2, 2024
Where G0011 sits
- 1G codesProcedures and professional services
- 2Active code G0011Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code G0011 mean?
G0011 is the HCPCS code for “Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G0011?
CMS lists G0011’s Medicare coverage as “Carrier judgment” and its pricing as “Physician fee schedule – Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside G0011
All G codesG0008Administration of influenza virus vaccineG0009Administration of pneumococcal vaccineG0010Administration of hepatitis b vaccineG0012Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscleG0013Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued…G0017Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than…G0018Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than…G0019Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other…G0022Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)