G0420 — Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
G0420 is a HCPCS Level II code for face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
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
- 2.12
- PE (non-facility)
- 1.15
- PE (facility)
- 1.15
- Malpractice RVU
- 0.13
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 G0420 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
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
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 G0420
- Long descriptor
- Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
- Short descriptor
- Ed svc ckd ind per session
- Added
- January 1, 2010
- BETOS
- M1B
- 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 G0420
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G0420 is not quite right, the correct code is very often within a few positions of it.
- G0412Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed
- G0413Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)
- G0414Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)
- G0415Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)
- G0416Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
- G0417Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimensterminated
- G0418Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimensterminated
- G0419Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimensterminated
- G0421Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour
- G0422Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session
- G0423Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session
- G0424Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per dayterminated
- G0425Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
- G0426Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth
- G0427Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth
- G0428Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)
Questions about G0420
What is HCPCS code G0420?
G0420 is a HCPCS Level II code for face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G0420?
The CMS HCPCS file marks G0420 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G0420 paid under the physician fee schedule?
G0420 carries PFS status code A. Active code. Paid separately under the physician fee schedule.