G3003 HCPCS code: Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)
G3003 is the HCPCS Level II code for each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.). In 2024 Medicare paid an average of $22.28 per service for G3003 across 33,407 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 rose 70% from 2023 to 2024 (19,654 to 33,407 services). In 2024, about 223 clinicians billed Medicare for G3003 for 7,140 beneficiaries; Florida, New Hampshire, Kentucky accounted for 61% 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 | P5E |
| Added | 2023-01-01 |
| Last action effective | 2023-01-01 |
Who bills G3003 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 223 |
| Medicare beneficiaries | 7,140 |
| States with claims | 25 |
| Share of services in top 3 states (Florida, New Hampshire, Kentucky) | 61% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G3003, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 19,654 | 4,566 | $28.39 | $22.57 |
| 2024 | 33,407 | 7,140 | $28.13 | $22.28 |
States with the most G3003 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 15,322 | $21.90 |
| New Hampshire | 2,750 | $22.20 |
| Kentucky | 2,276 | $23.54 |
| California | 2,154 | $23.37 |
| Tennessee | 1,670 | $21.02 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 4 | Code Descriptor / CPT Instruction |
| practitioner claims | 4 | Code Descriptor / CPT Instruction |
What changed for G3003
- 2023-01-01: G3003 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 G3003?
G3003 is the HCPCS Level II code for each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.). Short descriptor: "Chronic pain mgmt addl 15m".
How much does Medicare pay for G3003?
In 2024, the average Medicare payment was $22.28 per service (average allowed $28.13).
Does Medicare cover G3003?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of G3003 can be billed per day?
4 on outpatient hospital claims; 4 on practitioner claims (NCCI medically unlikely edits).
Related G30 codes
- G3001 — Administration and supply of tositumomab, 450 mg
- G3002 — Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.)
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Next steps
- Run a reimbursement report for a device billed under G3003
- Watch G3003 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G3003
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.