S0280 HCPCS code: Medical home program, comprehensive care coordination and planning, initial plan
S0280 is the HCPCS Level II code for medical home program, comprehensive care coordination and planning, initial plan. 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 | S codes — Temporary national codes (non-Medicare) |
| Coverage code | I — Not payable by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2010-01-01 |
| Last action effective | 2010-01-01 |
What changed for S0280
- 2010-01-01: S0280 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 S0280?
S0280 is the HCPCS Level II code for medical home program, comprehensive care coordination and planning, initial plan. Short descriptor: "Medical home, initial plan".
Does Medicare cover S0280?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related S02 codes
- S0201 — Partial hospitalization services, less than 24 hours, per diem
- S0207 — Paramedic intercept, non-hospital-based als service (non-voluntary), non-transport
- S0208 — Paramedic intercept, hospital-based als service (non-voluntary), non-transport
- S0209 — Wheelchair van, mileage, per mile
- S0215 — Non-emergency transportation; mileage, per mile
- S0220 — Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes
- S0221 — Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes
- S0250 — Comprehensive geriatric assessment and treatment planning performed by assessment team
- S0255 — Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff
- S0257 — Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)
- S0260 — History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)
- S0265 — Genetic counseling, under physician supervision, each 15 minutes
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Next steps
- Run a reimbursement report for a device billed under S0280
- Watch S0280 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for S0280
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.