`G0409` Corf related serv 15 mins ea

What G0409 is

Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)

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

Medicare payment for G0409 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	0.00	0.71	0.01	0.72	$24.05
Facility (hospital, ASC)	0.00	0.71	0.01	0.72	$24.05

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: Restricted coverage - payable only in specific circumstances. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps G0409 at 4 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: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with G0409? These codes are bundled into it

G0409 is a Column 1 code in 15 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
`90845`	Psychoanalysis	1 - modifier may bypass	Check pair
`90846`	Family psytx w/o pt 50 min	1 - modifier may bypass	Check pair
`90847`	Family psytx w/pt 50 min	1 - modifier may bypass	Check pair
`90849`	Multiple family group psytx	1 - modifier may bypass	Check pair
`90853`	Group psychotherapy	1 - modifier may bypass	Check pair
`90865`	Narcosynthesis	1 - modifier may bypass	Check pair
`90870`	Electroconvulsive therapy	1 - modifier may bypass	Check pair
`90880`	Hypnotherapy	1 - modifier may bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair
`G0155`	Hhcp-svs of csw,ea 15 min	1 - modifier may bypass	Check pair
`G0176`	Opps/php/iop; activity thrpy	1 - modifier may bypass	Check pair
`G0177`	Opps/php/iop; train & educ	1 - modifier may bypass	Check pair
`G0459`	Telehealth inpt pharm mgmt	1 - modifier may bypass	Check pair

G0409 is bundled into these codes

G0409 appears as a Column 2 code in 9 active edits. Reported with one of these Column 1 codes on the same date of service, G0409 is the code that denies.

Column 1 code	Short description	Modifier indicator
`90791`	Psych diagnostic evaluation	1	Check pair
`90792`	Psych diag eval w/med srvcs	1	Check pair
`90832`	Psytx w pt 30 minutes	1	Check pair
`90833`	Psytx w pt w e/m 30 min	1	Check pair
`90834`	Psytx w pt 45 minutes	1	Check pair
`90836`	Psytx w pt w e/m 45 min	1	Check pair
`90837`	Psytx w pt 60 minutes	1	Check pair
`90838`	Psytx w pt w e/m 60 min	1	Check pair
`90839`	Psytx crisis initial 60 min	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.