S0265 — Genetic counseling, under physician supervision, each 15 minutes
S0265 is a HCPCS Level II code for genetic counseling, under physician supervision, each 15 minutes. It belongs to the Temporary National Codes (Non-Medicare) section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
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 statusI
Not valid for Medicare purposes. Medicare uses another code.
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 S0265
- Long descriptor
- Genetic counseling, under physician supervision, each 15 minutes
- Short descriptor
- Genetic counsel 15 mins
- Added
- July 1, 2005
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
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.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to S0265
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If S0265 is not quite right, the correct code is very often within a few positions of it.
- S0209Wheelchair van, mileage, per mile
- S0215Non-emergency transportation; mileage, per mile
- S0220Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes
- S0221Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes
- S0250Comprehensive geriatric assessment and treatment planning performed by assessment team
- S0255Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff
- S0257Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)
- S0260History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)
- S0270Physician management of patient home care, standard monthly case rate (per 30 days)
- S0271Physician management of patient home care, hospice monthly case rate (per 30 days)
- S0272Physician management of patient home care, episodic care monthly case rate (per 30 days)
- S0273Physician visit at member's home, outside of a capitation arrangement
- S0274Nurse practitioner visit at member's home, outside of a capitation arrangement
- S0280Medical home program, comprehensive care coordination and planning, initial plan
- S0281Medical home program, comprehensive care coordination and planning, maintenance of plan
- S0285Colonoscopy consultation performed prior to a screening colonoscopy procedure
Questions about S0265
What is HCPCS code S0265?
S0265 is a HCPCS Level II code for genetic counseling, under physician supervision, each 15 minutes. It sits in the Temporary National Codes (Non-Medicare) section.
Does Medicare cover S0265?
The CMS HCPCS file marks S0265 as "Not payable by Medicare". Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
How is S0265 paid under the physician fee schedule?
S0265 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.