G0101 — Cervical or vaginal cancer screening; pelvic and clinical breast examination
G0101 is a HCPCS Level II code for cervical or vaginal cancer screening; pelvic and clinical breast examination. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusA
Active code. Paid separately under the physician fee schedule.
- Work RVU
- 0.44
- PE (non-facility)
- 0.68
- PE (facility)
- 0.23
- Malpractice RVU
- 0.07
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of G0101 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
- outpatient
- 1 unit MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for G0101
- Long descriptor
- Cervical or vaginal cancer screening; pelvic and clinical breast examination
- Short descriptor
- Ca screen;pelvic/breast exam
- Added
- January 1, 1998
- BETOS
- M1A
- Pricing indicator
- 11 — Physician fee schedule
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Price established using national RVUs.
Codes adjacent to G0101
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G0101 is not quite right, the correct code is very often within a few positions of it.
- G0083Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
- G0084Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
- G0085Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
- G0086Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
- G0087Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
- G0088Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes
- G0089Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
- G0090Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes
- G0102Prostate cancer screening; digital rectal examination
- G0103Prostate cancer screening; prostate specific antigen test (psa)
- G0104Colorectal cancer screening; flexible sigmoidoscopy
- G0105Colorectal cancer screening; colonoscopy on individual at high risk
- G0106Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enematerminated
- G0108Diabetes outpatient self-management training services, individual, per 30 minutes
- G0109Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
- G0117Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
Questions about G0101
What is HCPCS code G0101?
G0101 is a HCPCS Level II code for cervical or vaginal cancer screening; pelvic and clinical breast examination. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G0101?
The CMS HCPCS file marks G0101 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is G0101 paid under the physician fee schedule?
G0101 carries PFS status code A. Active code. Paid separately under the physician fee schedule.