G0379 Direct refer hospital observ

What G0379 is

Direct admission of patient for hospital observation care

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

Medicare payment for G0379 (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 G0379 at 0 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: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with G0379? These codes are bundled into it

G0379 is a Column 1 code in 9 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.

G0379 is bundled into these codes

G0379 appears as a Column 2 code in 11 active edits. Reported with one of these Column 1 codes on the same date of service, G0379 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.