Part of Community Health Integration
HCPCS G0019: Community Health Integration, first 60 minutes
First 60 minutes per calendar month of community health integration services, connecting a patient to community-based resources that address a documented unmet social need.
Time threshold & code combinations
First 60 minutes of certified/trained auxiliary personnel time per calendar month.
- G0022 is the add-on for each additional 30 minutes beyond this threshold
- Not billed alongside CCM, PCM, or TCM for the same patient using the same time or activities in the same month
Who can bill
- Physicians
- Non-physician practitioners eligible to bill E/M services (via auxiliary personnel under general supervision)
Eligibility & billing requirements
- Initiating visit documents an SDOH risk assessment with a specific unmet social need interfering with treatment
- Documented patient consent
- Person-centered plan for addressing the identified social need
- Identification of, and referral to, applicable community-based resources and organizations
- Practical assistance with accessing those resources (e.g., scheduling, applications, transportation arrangements)
- Follow-up to confirm the patient connected with the referred resource
When to use it
Housing instability interfering with diabetes management
A community health worker spends 60 minutes identifying local housing assistance programs, helping the patient complete an application, and documenting the plan and referral in the chart.
Billing: G0019
Documentation checklist
- Time log showing at least 60 minutes
- SDOH risk assessment identifying the unmet need
- Person-centered plan and referral documentation
Common billing mistakes
- Billing G0019 without a documented SDOH risk assessment tied to a specific unmet need
- Billing G0019 and CCM/PCM for the same time and activities in the same month