G0313 HCPCS code: Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)
G0313 is the HCPCS Level II code for immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes). Its Medicare coverage code is I (Not payable by Medicare): Medicare does not pay separately under this code; another code applies.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | I — Not payable by Medicare |
| Pricing indicator | 99 |
| BETOS category | M5D |
| Added | 2022-05-11 |
| Last action effective | 2022-05-11 |
What changed for G0313
- 2022-05-11: G0313 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 G0313?
G0313 is the HCPCS Level II code for immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes). Short descriptor: "Immunize couns < 21yr 6-30 m".
Does Medicare cover G0313?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related G03 codes
- G0300 — Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes
- G0302 — Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services
- G0303 — Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services
- G0304 — Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services
- G0305 — Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services
- G0306 — Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count
- G0307 — Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)
- G0308 — Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor, including system activation and patient training
- G0309 — Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor, including system activation
- G0310 — Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)
- G0311 — Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid billing purposes)
- G0312 — Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)
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Next steps
- Run a reimbursement report for a device billed under G0313
- Watch G0313 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0313
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.