G0402 HCPCS Level II code: Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
G0402 is the HCPCS code for “Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
Short description: Initial preventive exam
HCPCS · United States
Notes for G0402
As CMS prints them, with any note G0402 takes from the headings above it.
Note
- CMS processing note 0153: PURSUANT TO SECTION 101 (B) OF THE MEDICARE IMPROVEMENT FOR PATIENTS AND PROVIDERS ACT OF 2008 (MIPPA) EFFECTIVE JANUARY 1, 2009, WE EXPANDED COVERAGE FOR THE WELCOME TO MEDICARE BENEFIT; IT IS SUBJECT TO CERTAIN ELIGIBILITY AND OTHER LIMITATIONS THAT ALLOW PAYMENT FOR AN INITIAL PREVENTIVE PHYSICAL EXAMINATION (IPPE), NOT LATER THAN 12 MONTHS AFTER THE DATE THE INDIVIDUAL'S FIRST COVERAGE PERIOD BEGINS UNDER MEDICARE PART B.
Medicare details
The indicators CMS publishes with G0402 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 using national RVUs
- Type of service
- Medical care
- BETOS category
- Office visits - new
- Added
- Jan 1, 2009
Where G0402 sits
- 1G codesProcedures and professional services
- 2Active code G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
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 G0402 mean?
G0402 is the HCPCS code for “Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G0402?
CMS lists G0402’s Medicare coverage as “Carrier judgment” and its pricing as “Physician fee schedule – Price established using national RVUs”. 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 G0402
All G codesG0390Trauma response team associated with hospital critical care serviceG0396Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutesG0397Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutesG0398Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturationG0399Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturationG0400Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channelsG0403Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and reportG0404Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examinationG0405Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examinationG0406Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealthG0407Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealthG0408Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth