G0175 Opps service,sched team conf

What G0175 is

Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present

HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.

Medicare payment for G0175 (CY2026)

This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

Medically Unlikely Edit (MUE)

Medicare caps G0175 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with G0175? These codes are bundled into it

G0175 is a Column 1 code in 18 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

G0175 is bundled into these codes

G0175 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, G0175 is the code that denies.

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.