G0513 HCPCS Level II code: Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient…
G0513 is the HCPCS code for “Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first…” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G0513Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
Short description: Prolong prev svcs, first 30m
HCPCS · United States
Medicare details
The indicators CMS publishes with G0513 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, 2018
Where G0513 sits
- 1G codesProcedures and professional services
- 2Active code G0513Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
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 G0513 mean?
G0513 is the HCPCS code for “Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G0513?
CMS lists G0513’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 G0513
All G codesG0506Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)G0507Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per…G0508Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealthG0509Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealthG0511Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management…G0512Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for…G0514Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the…G0515Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutesG0516Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)G0517Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)G0518Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)G0519Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model