Medicare Claims Processing Manual (Pub. 100-04), Ch. 32 § 60.5.1
HCPCS for Carriers
60.5.1 - HCPCS for Carriers
(Rev. 1562, Issued: 07-25-08, Effective: 03-19-08, Implementation: 08-25-08)
For services furnished on or after July 1, 2002, and prior to March 19, 2008, the applicable HCPCS codes for this
benefit are:
G0248: Demonstration, at initial use, of home INR monitoring for patient with mechanical heart valve(s) who meets
Medicare coverage criteria, under the direction of a physician; includes: demonstration use and care of the INR
monitor, obtaining at least one blood sample, provision of instructions for reporting home INR test results and
documentation of a patient’s ability to perform testing.
Short Description: Demonstrate use home INR mon
G0249: Provision of test materials and equipment for home INR monitoring to patient with mechanical heart valve(s)
who meets Medicare coverage criteria. Includes provision of materials for use in the home and reporting of test
results to physician; per 4 tests.
Short Description: Provide test material, equipm
G0250: Physician review; interpretation and patient management of home INR testing for a patient with mechanical
heart valve(s) who meets other coverage criteria; per 4 tests (does not require face-to-face).
Short Description: MD review interpret of test
For services furnished on or after March 19, 2008, the applicable HCPCS codes for this benefit are:
G0248: Demonstration, prior to initial use, of home INR monitoring for patient with either mechanical heart
valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria, under the
direction of a physician; includes: face-to-face demonstration of use and care of the INR monitor, obtaining at least
one blood sample, provision of instructions for reporting home INR test results, and documentation of patient ability
to perform testing prior to its use
Short Description: Demonstrate use home INR mon
G0249: Provision of test materials and equipment for home INR monitoring of patient with either mechanical heart
valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes
provision of materials for use in the home and reporting of test results to physician; not occurring more frequently
than once a week
Short Description: Provide INR test mater/equip
G0250: Physician review, interpretation, and patient management of home INR testing for a patient with either
mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage
criteria; includes face-to-face verification by the physician that the patient uses the device in the context of the
management of the anticoagulation therapy following initiation of the home INR monitoring; not occurring more
frequently than once a week
Short Description: MD INR test revie inter mgmt