S0280: Medical home program, comprehensive care coordination and planning, initial plan
S0280 is a HCPCS Level II code for medical home program, comprehensive care coordination and planning, initial plan. It belongs to the Temporary National Codes (Non-Medicare) section. Medicare does not pay it: see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusI
Not valid for Medicare purposes. Medicare uses another code.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for S0280
- Long descriptor
- Medical home program, comprehensive care coordination and planning, initial plan
- Short descriptor
- Medical home, initial plan
- Added
- January 1, 2010
- BETOS
- Z2
- Pricing indicator
- 00: Not priced by Part B
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.
Service not separately priced by Part B, not covered, bundled into another service, or used by Part A only.
Codes adjacent to S0280
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If S0280 is not quite right, the correct code is very often within a few positions of it.
- S0257Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)
- S0260History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)
- S0265Genetic counseling, under physician supervision, each 15 minutes
- S0270Physician management of patient home care, standard monthly case rate (per 30 days)
- S0271Physician management of patient home care, hospice monthly case rate (per 30 days)
- S0272Physician management of patient home care, episodic care monthly case rate (per 30 days)
- S0273Physician visit at member's home, outside of a capitation arrangement
- S0274Nurse practitioner visit at member's home, outside of a capitation arrangement
- S0281Medical home program, comprehensive care coordination and planning, maintenance of plan
- S0285Colonoscopy consultation performed prior to a screening colonoscopy procedure
- S0302Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)
- S0310Hospitalist services (list separately in addition to code for appropriate evaluation and management service)
- S0311Comprehensive management and care coordination for advanced illness, per calendar month
- S0315Disease management program; initial assessment and initiation of the program
- S0316Disease management program, follow-up/reassessment
- S0317Disease management program; per diem