G0390 Trauma respons w/hosp criti

Trauma response team associated with hospital critical care service

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for G0390

Physician Fee Schedule (CY 2026, RVU26D)

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

Payer policies and prior authorization for G0390

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • MS: $1012.23 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $1034.95 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $589.46 (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.