`G0136` Adm of pa/n assess 5-15 m

Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months

Medicare coverage: Carrier judgment
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 1 units per day (clinical), rationale: Code Descriptor / CPT Instruction
Outpatient hospital: max 1 units per day (clinical), rationale: Code Descriptor / CPT Instruction

Medicare pricing for G0136

Physician Fee Schedule (CY 2026, RVU26D)

Status A: active, paid separately under the PFS if covered. National amounts: non-facility $20.04, facility $8.02 (total RVUs 0.60 / 0.24 × $33.4009 conversion factor). Work RVU 0.18, practice expense RVU 0.41 non-facility and 0.05 facility, malpractice RVU 0.01. Global period XXX. Qualifying APM participants are paid at a $33.5675 conversion factor.

Payer policies and prior authorization for G0136

Payer coverage policies that name G0136

G0136 appears in 1 coverage policy from Premera Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Premera Blue Cross	Non-covered Services and Procedures Page \| 15 of 30 \| ∞	listed, no stance	Jun 1, 2026	payer document

Medicaid fee-for-service

IN: $7.11 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
LA: $14.84 (professional), effective Jul 1, 2025
ND: $0.00 (physician), effective Aug 1, 2026
VT: $29.09 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $5.23 (epsdt, facility), effective Jan 1, 2027
WY: $16.57 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

G0136 Adm of pa/n assess 5-15 m