G0454 HCPCS Level II code: Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical…
G0454 is the HCPCS code for “Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G0454Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist
Short description: Md document visit by npp
HCPCS · United States
Medicare details
The indicators CMS publishes with G0454 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
- Specialist - other
- Added
- Jan 1, 2013
Where G0454 sits
- 1G codesProcedures and professional services
- 2Active code G0454Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist
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 G0454 mean?
G0454 is the HCPCS code for “Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G0454?
CMS lists G0454’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.
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