G-Codes Set Up

Here are some easy steps to help you set up your G-Codes.

Create your Medicare Insurance Company

Please see this article on how to set up the insurance: Insurance Company Set Up

Once created Edit the Medicare Company -> Rule Tab

Make sure you bring over the G-Codes and Listed Codes Only rule, and hit apply changes once done.

Inside the Plan Tab, click on the plan, then click on the Advanced tab.

G-Codes = Yes, PQRS = NO, and put checks in both the MRPP and Sequestor boxes.

Hit apply changes, then head over to the Company Rates tab and click Add Rate.

You will get a Pop-up to create the company Rates:

RED: Choose Code
ORANGE: Enter Rate (this can either be facility rate or contacted rate - this is what will show on the claim)
YELLOW: Enter the Allowed amount if you know it (optional)
GREEN: Add GP Modifier for Medicare
PINK: Click Create
Repeat for all CPT Codes

If you already have the Rates in another insurance that you want to add here, go to that plan and click on the Copy Rates button:

You will get a pop-up that says where it is copying from and to:

*The system will prompt you every 10 visits from last input to send G-codes with your billing.*

**You Enter the G-Codes in the CPT Code Screen, not in the documentation itself; if you do not have things set up properly the button will not appear.**

***The CPT and G-Codes do not show up on the Eval, Progress Note,or Discharge. You can either manually enter them in only of the text boxes in that documentation or Create a Daily Note. If you do not want to write a whole Daily Note you can write "See Eval of same DOS." The Daily Note will then Contain that little statement, the procedure codes, and your Experience Log (if you completed one.)***