G0318 HCPCS code: Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes)
G0318 is the HCPCS Level II code for prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes). In 2024 Medicare paid an average of $21.79 per service for G0318 across 155,127 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 4 per day on outpatient hospital claims. Medicare volume fell 24% from 2023 to 2024 (202,785 to 155,127 services). In 2024, about 3,184 clinicians billed Medicare for G0318 for 42,887 beneficiaries; Florida, California, Texas accounted for 53% of services.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 11 — Priced using national relative value units (Physician Fee Schedule) |
| BETOS category | Y1 |
| Added | 2023-01-01 |
| Last action effective | 2023-01-01 |
Who bills G0318 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3,184 |
| Medicare beneficiaries | 42,887 |
| States with claims | 50 |
| Share of services in top 3 states (Florida, California, Texas) | 53% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G0318, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 202,785 | 43,129 | $28.10 | $22.10 |
| 2024 | 155,127 | 42,887 | $27.89 | $21.79 |
States with the most G0318 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 30,798 | $21.98 |
| California | 28,120 | $24.00 |
| Texas | 22,726 | $20.58 |
| Maryland | 7,573 | $21.35 |
| New York | 6,974 | $26.65 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 4 | Clinical: Data |
| practitioner claims | 4 | Clinical: Data |
What changed for G0318
- 2023-01-01: G0318 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 G0318?
G0318 is the HCPCS Level II code for prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes). Short descriptor: "Prolong home eval add 15m".
How much does Medicare pay for G0318?
In 2024, the average Medicare payment was $21.79 per service (average allowed $27.89).
Does Medicare cover G0318?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of G0318 can be billed per day?
4 on outpatient hospital claims; 4 on practitioner claims (NCCI medically unlikely edits).
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 G0318
- Watch G0318 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0318
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.