G0313 Insurance Policy Changes

HCPCS G0313 is officially defined as "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)." HCPCS G0313 is referenced in 1 tracked payer policy change from Kansas Medicaid (KanCare). For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS G0313 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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All billing codesJ35909921299213992029921199214

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