G0136 HCPCS code: Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months
G0136 is the HCPCS Level II code for administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months. In 2024 Medicare paid an average of $12.71 per service for G0136 across 174,328 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on outpatient hospital claims. In 2024, about 7,096 clinicians billed Medicare for G0136 for 160,591 beneficiaries; North Carolina, Pennsylvania, New York accounted for 27% of services.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 13 |
| BETOS category | M5D |
| Added | 2024-01-01 |
| Last action effective | 2026-01-01 |
Who bills G0136 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 7,096 |
| Medicare beneficiaries | 160,591 |
| States with claims | 50 |
| Share of services in top 3 states (North Carolina, Pennsylvania, New York) | 27% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G0136, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 174,328 | 160,591 | $16.52 | $12.71 |
States with the most G0136 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| North Carolina | 17,265 | $13.01 |
| Pennsylvania | 15,747 | $15.33 |
| New York | 13,711 | $14.62 |
| Florida | 10,738 | $13.64 |
| Maryland | 10,257 | $13.41 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
What changed for G0136
- January 2026: Descriptor revised (Was: Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes)
- 2024-01-01: G0136 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G0136?
G0136 is the HCPCS Level II code for administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months. Short descriptor: "Adm of pa/n assess 5-15 m".
How much does Medicare pay for G0136?
In 2024, the average Medicare payment was $12.71 per service (average allowed $16.52).
Does Medicare cover G0136?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of G0136 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related G01 codes
- G0101 — Cervical or vaginal cancer screening; pelvic and clinical breast examination
- G0102 — Prostate cancer screening; digital rectal examination
- G0103 — Prostate cancer screening; prostate specific antigen test (PSA)
- G0104 — Colorectal cancer screening; flexible sigmoidoscopy
- G0105 — Colorectal cancer screening; colonoscopy on individual at high risk
- G0106 — Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema
- G0108 — Diabetes outpatient self-management training services, individual, per 30 minutes
- G0109 — Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
- G0117 — Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
- G0118 — Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist
- G0120 — Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
- G0121 — Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under G0136
- Watch G0136 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0136
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.