HCPCS code G0536 — Peer recover support svs. Status: Active. Effective Jan 1, 2025. Source: CMS HCPCS Level II.

G0536

Active

Peer recover support svs

Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes; developing and proposing strategies to help meet person-centered treatment goals; assisting the patient in locating or navigating recovery support services; each additional 30 minutes of services (provision of the services by a medicare-enrolled opioid treatment program); (list separately in addition to each primary code)

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: Jan 1, 2025
Code type: alphanumeric
OPPS Status: A — Paid under a separate fee schedule (not OPPS)

MUE — Medically Unlikely Edits

Maximum units of G0536 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
Outpatient Hospital 1
Practitioner Services 1

Source: CMS Medicare NCCI Medically Unlikely Edits

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2025-Q1
    Peer recover support svs