`G3003` Chronic pain mgmt addl 15m

Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)

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

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 4 units per day (clinical), rationale: Code Descriptor / CPT Instruction
Outpatient hospital: max 4 units per day (clinical), rationale: Code Descriptor / CPT Instruction

Medicare pricing for G3003

Physician Fee Schedule (CY 2026, RVU26D)

Status A: active, paid separately under the PFS if covered. National amounts: non-facility $31.73, facility $22.71 (total RVUs 0.95 / 0.68 × $33.4009 conversion factor). Work RVU 0.50, practice expense RVU 0.40 non-facility and 0.13 facility, malpractice RVU 0.05. Global period ZZZ. Qualifying APM participants are paid at a $33.5675 conversion factor.

Payer policies and prior authorization for G3003

Payer coverage policies that name G3003

G3003 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Chronic Pain Rehabilitation Programs (0237)	covered if criteria are met	Apr 23, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

ND: $0.00 (physician), effective Aug 1, 2026
TX: $23.26 (home_health_agency, Home Health Agency, non-facility), effective Mar 1, 2024
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.

G3003 Chronic pain mgmt addl 15m