HCPCS Code G0463: Hospital Outpatient Clinic Visit for Assessment of a Patient

Learn about HCPCS Code G0463 for hospital outpatient clinic visits, billing guidelines, and documentation for accurate billing and reimbursement process.

Use Code

Frequently asked questions

G0463 is a HCPCS code used by hospitals to bill for outpatient clinic visits for assessment and management services of a patient. It represents the facility fee for hospital outpatient clinics.

G0463 is a hospital facility code for outpatient clinic visits billed by hospitals, whereas 99214 is a CPT code used by physicians for evaluation and management services. G0463 covers facility costs; 99214 covers professional services. Note that medical necessity is needed for 99214.

Medicaid acceptance of G0463 varies by state, but many Medicaid services do accept it for hospital outpatient department billing. Providers, billing companies, and medical coding specialists should verify acceptance with their specific Medicaid plans.