HCPCS Level II · Procedures and professional services (temporary)
G0528Management of established patient with dementia, moderate to high complexity, for use in cmmi model
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Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About G0528
G0528 is an HCPCS Level II code in the G series (procedures and professional services (temporary)), describing management of established patient with dementia, moderate to high complexity, for use in cmmi model.
It was added to HCPCS effective 07/01/2024.
Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.
Details
- Short description
- Mgt est pt dem mod-hi cmplx
- Date added
- 07/01/2024
- Action effective
- 07/01/2024
- BETOS
- Z2
Related G05xx codes
- G0500Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)
- G0501Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)
- G0506Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
- G0508Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
- G0509Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
- G0513Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
- G0514Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)
- G0516Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
- G0517Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
- G0518Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
- G0519Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model
- G0520Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
Common questions about G0528
Is HCPCS G0528 still valid?
- Yes. G0528 is active in the CMS October 2026 HCPCS file.
Does Medicare cover G0528?
- Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.