S0315 — Disease management program; initial assessment and initiation of the program
S0315 is a HCPCS Level II code for disease management program; initial assessment and initiation of the program. 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 2026Q3-Jul. 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 S0315
- Long descriptor
- Disease management program; initial assessment and initiation of the program
- Short descriptor
- Disease management program
- Added
- October 1, 2002
- 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 S0315
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If S0315 is not quite right, the correct code is very often within a few positions of it.
- S0273Physician visit at member's home, outside of a capitation arrangement
- S0274Nurse practitioner visit at member's home, outside of a capitation arrangement
- S0280Medical home program, comprehensive care coordination and planning, initial plan
- 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
- S0316Disease management program, follow-up/reassessment
- S0317Disease management program; per diem
- S0320Telephone calls by a registered nurse to a disease management program member for monitoring purposes; per month
- S0340Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage
- S0341Lifestyle modification program for management of coronary artery disease, including all supportive services; second or third quarter / stage
- S0342Lifestyle modification program for management of coronary artery disease, including all supportive services; fourth quarter / stage
- S0353Treatment planning and care coordination management for cancer, initial treatment
- S0354Treatment planning and care coordination management for cancer, established patient with a change of regimen
Questions about S0315
What is HCPCS code S0315?
S0315 is a HCPCS Level II code for disease management program; initial assessment and initiation of the program. It sits in the Temporary National Codes (Non-Medicare) section.
Does Medicare cover S0315?
The CMS HCPCS file marks S0315 as "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.
How is S0315 paid under the physician fee schedule?
S0315 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.