G0383 Lev 4 hosp type b ed visit

Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for G0383

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for G0383

Payer coverage policies that name G0383

G0383 appears in 1 coverage policy from Blue Cross NC.

PayerPolicyRole in policyReviewedDocument
Blue Cross NCFacility Emergency Department E&M Serviceslisted, no stanceOct 1, 2025payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • IL: $44.00 (practitioner), effective Jan 1, 2007
  • KS: $59.84 (er_facility, OUTPATIENT SERVICES - FOR OUTPATIENT HOSPITAL CLAIMS, facility), effective Jul 1, 2018
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $205.22 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $116.89 (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.