`G0238` Oth resp proc, indiv

What G0238 is

Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)

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

Medicare payment for G0238 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	0.00	0.33	0.01	0.34	$11.36
Facility (hospital, ASC)	0.00	0.33	0.01	0.34	$11.36

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps G0238 at 8 units 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: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with G0238? These codes are bundled into it

G0238 is a Column 1 code in 41 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.

Column 2 code	Short description	Modifier indicator
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`94010`	Breathing capacity test	1 - modifier may bypass	Check pair
`94060`	Evaluation of wheezing	1 - modifier may bypass	Check pair
`94150`	Vital capacity test	1 - modifier may bypass	Check pair
`94200`	Lung function test (mbc/mvv)	1 - modifier may bypass	Check pair
`94375`	Respiratory flow volume loop	1 - modifier may bypass	Check pair
`94450`	Breathing response hypoxia	1 - modifier may bypass	Check pair
`94617`	Exercise tst brncspsm w/ecg	0 - no modifier bypass	Check pair
`94618`	Pulmonary stress testing	0 - no modifier bypass	Check pair
`94621`	Cardiopulm exercise testing	0 - no modifier bypass	Check pair
`94667`	Mnpj chest wall 1st	0 - no modifier bypass	Check pair
`94668`	Mnpj chest wall sbsq	0 - no modifier bypass	Check pair
`94669`	Mechanical chest wall oscill	0 - no modifier bypass	Check pair
`94680`	O2 uptk rst&xers dir simple	1 - modifier may bypass	Check pair
`94681`	O2 uptk co2 outp % o2 xtrc	1 - modifier may bypass	Check pair
`94690`	O2 uptk rest indirect	1 - modifier may bypass	Check pair
`94726`	Plethysmography lung volumes	1 - modifier may bypass	Check pair
`94727`	Gas dil/wshot deter lng vol	1 - modifier may bypass	Check pair
`94728`	Airwy resist by oscillometry	1 - modifier may bypass	Check pair
`94729`	Diffusing capacity	1 - modifier may bypass	Check pair
`94760`	N-invas ear/pls oximetry 1	0 - no modifier bypass	Check pair
`94761`	N-invas ear/pls oximetry mlt	0 - no modifier bypass	Check pair
`94762`	N-invas ear/pls oximtry cont	1 - modifier may bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair
`97110`	Therapeutic exercises	1 - modifier may bypass	Check pair
`97112`	Neuromuscular reeducation	1 - modifier may bypass	Check pair
`97150`	Group therapeutic procedures	1 - modifier may bypass	Check pair
`97161`	Pt eval low complex 20 min	1 - modifier may bypass	Check pair
`97162`	Pt eval mod complex 30 min	1 - modifier may bypass	Check pair

Showing 30 of 41 column 2 codes. Use the pair checker for any specific combination.

G0238 is bundled into these codes

G0238 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, G0238 is the code that denies.

Column 1 code	Short description	Modifier indicator
`G0239`	Oth resp proc, group	1	Check pair

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.