G0235 HCPCS code: Pet imaging, any site, not otherwise specified

G0235 is the HCPCS Level II code for pet imaging, any site, not otherwise specified. Its Medicare coverage code is M (Non-covered by Medicare): Medicare does not cover this item or service. The NCCI unit limit is 1 per day on outpatient hospital claims.

Code details

NCCI unit limits (MUE)

Medicare policy articles for this code

• A53134: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
• A59049: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
• A59318: Billing and Coding: Positron Emission Tomography (PET) Scan for Inflammation and Infection (CGS Administrators, LLC (MAC - Part A, MAC - Part B))

Covered diagnoses (140 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

Showing 10 of 140. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for G0235

• 2006-01-01: G0235 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 G0235?

G0235 is the HCPCS Level II code for pet imaging, any site, not otherwise specified. Short descriptor: "Pet not otherwise specified".

Does Medicare cover G0235?

Coverage code M — Non-covered by Medicare. Medicare does not cover this item or service.

Which diagnoses support coverage for G0235?

Medicare policy articles that cite G0235 list 140 covered ICD-10-CM diagnosis codes across 3 articles. The most cited include F03.90 (Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety), F03.911 (Unspecified dementia, unspecified severity, with agitation), F03.918 (Unspecified dementia, unspecified severity, with other behavioral disturbance). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

How many units of G0235 can be billed per day?

1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).

Related G02 codes

• G0202 — Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed
• G0204 — Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral
• G0206 — Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral
• G0219 — Pet imaging whole body; melanoma for non-covered indications
• G0237 — Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)
• G0238 — Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)
• G0239 — Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)
• G0245 — Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education
• G0246 — Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education
• G0247 — Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails
• G0248 — Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results
• G0249 — Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests

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Next steps

• Run a reimbursement report for a device billed under G0235
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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.

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