G0296 — Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)
G0296 is a HCPCS Level II code for counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making). It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusA
Active code. Paid separately under the physician fee schedule.
- Work RVU
- 0.52
- PE (non-facility)
- 0.31
- PE (facility)
- 0.12
- Malpractice RVU
- 0.03
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of G0296 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
- outpatient
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for G0296
- Long descriptor
- Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)
- Short descriptor
- Visit to determ ldct elig
- Added
- February 5, 2015
- BETOS
- M6
- Pricing indicator
- 13 — Physician fee schedule
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Price established by carriers — not otherwise classified, individual determination, or carrier discretion.
Codes adjacent to G0296
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G0296 is not quite right, the correct code is very often within a few positions of it.
- G0281Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care
- G0282Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281
- G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care
- G0288Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery
- G0289Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee
- G0293Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day
- G0294Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day
- G0295Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses
- G0297Low dose ct scan (ldct) for lung cancer screeningterminated
- G0299Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes
- G0300Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes
- G0302Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services
- G0303Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services
- G0304Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services
- G0305Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services
- G0306Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count
Questions about G0296
What is HCPCS code G0296?
G0296 is a HCPCS Level II code for counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G0296?
The CMS HCPCS file marks G0296 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G0296 paid under the physician fee schedule?
G0296 carries PFS status code A. Active code. Paid separately under the physician fee schedule.