G0238 HCPCS code: Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)

G0238 is the HCPCS Level II code for therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring). In 2024 Medicare paid an average of $8.26 per service for G0238 across 76,892 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 8 per day on outpatient hospital claims. Medicare volume rose 91% from 2022 to 2024 (40,330 to 76,892 services). In 2024, about 225 clinicians billed Medicare for G0238 for 1,102 beneficiaries; Illinois, Nevada, New Jersey accounted for 89% of services.

Code details

Who bills G0238 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for G0238, 2022–2024

States with the most G0238 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A56152: Billing and Coding: Pulmonary Rehabilitation Services (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
• A56717: Billing and Coding: Respiratory Therapy (Respiratory Care) (Palmetto GBA (MAC - Part A))
• A57224: Billing and Coding: Respiratory Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))

Covered diagnoses (1,109 ICD-10-CM codes)

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

Showing 10 of 1,109. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for G0238

• 2002-01-01: G0238 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 G0238?

G0238 is the HCPCS Level II code for therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring). Short descriptor: "Oth resp proc, indiv".

How much does Medicare pay for G0238?

In 2024, the average Medicare payment was $8.26 per service (average allowed $10.50).

Does Medicare cover G0238?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for G0238?

Medicare policy articles that cite G0238 list 1,109 covered ICD-10-CM diagnosis codes across 3 articles. The most cited include J41.1 (Mucopurulent chronic bronchitis), J41.8 (Mixed simple and mucopurulent chronic bronchitis), J43.0 (Unilateral pulmonary emphysema [MacLeod's syndrome]). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

How many units of G0238 can be billed per day?

8 on outpatient hospital claims; 8 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
• G0235 — Pet imaging, any site, not otherwise specified
• G0237 — Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 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

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Sources: CMS HCPCS Level II release October 2025; 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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