G0530 — Adult day center, 8-hour unit, for use in cmmi model
G0530 is a HCPCS Level II code for adult day center, 8-hour unit, for use in cmmi model. 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 statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for G0530
- Long descriptor
- Adult day center, 8-hour unit, for use in cmmi model
- Short descriptor
- Adult daycare center, 8 hr u
- Added
- July 1, 2024
- BETOS
- Z2
- Pricing indicator
- 13 — 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 by carriers — not otherwise classified, individual determination, or carrier discretion.
Codes adjacent to G0530
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G0530 is not quite right, the correct code is very often within a few positions of it.
- G0522Management of a new patient with dementia, low complexity, for use in cmmi model
- G0523Management of a new patient with dementia, moderate to high complexity, for use in cmmi model
- G0524Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model
- G0525Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
- G0526Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model
- G0527Management of established patient with dementia, low complexity, for use in cmmi model
- G0528Management of established patient with dementia, moderate to high complexity, for use in cmmi model
- G0529In-home respite care, 4-hour unit, for use in cmmi model
- G0531Facility-based respite, 24-hour unit, for use in cmmi model
- G0532Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)
- G0533Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)
- G0534Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose or treat an opioid use disorder; 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)
- G0535Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and goals; 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)
- G0536Peer 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)
- G0537Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months
- G0538Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month
Questions about G0530
What is HCPCS code G0530?
G0530 is a HCPCS Level II code for adult day center, 8-hour unit, for use in cmmi model. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G0530?
The CMS HCPCS file marks G0530 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 G0530 paid under the physician fee schedule?
G0530 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.