HCPCS code G2083: Administration of esketamine nasal spray, greater than 56 mg

Learn more about HCPCS code G2083, its code description, documentation requirements, and billing guidelines for proper use and billing. ‍

Use Code

What is HCPCS code H2083?

HCPCS code H2083, a "G" code established by the Center for Medicare & Medicaid Services (CMS), describes a bundled service for the administration of esketamine nasal spray. This code is specifically for an office or other outpatient visit for the evaluation and management of an established patient.

Though this code is for a self-administration of the nasal spray, a physician or other qualified health care professional must still be responsible for the supervision and 2 hours post administration observation.

HCPCS code G2083 documentation requirements

Required documentation for G2083 includes:

Patient medical record and identification
Risk evaluation and mitigation strategy
Dose and supervision by a qualified healthcare professional
Post-administration observation

G2083 billing requirements

To bill G2083, the following requirements and guidelines must be followed:

G2083 is a bundled code. Do not bill for the drug separately or for the observation time using other prolonged service codes.
For Medicare claims, the KX modifier may be required to indicate that the provider and facility are enrolled in the FDA's Risk Evaluation and Mitigation Strategy or REMS program.
The patient must be established or have received professional service from the same physician or another qualified health care professional within the past 3 years.
The site of service is considered.
Is aware of the payer-specific rules.

Other relevant codes

G2082: Administration of esketamine nasal spray, up to 56 mg
S0013: Esketamine, (Spravato) nasal spray, 1mg

Frequently asked questions

G2082 is for doses up to 56 mg, while H2083 is for doses greater than 56 mg.

The REMS program is a safety strategy required by the FDA to manage the known risks of a drug. For esketamine, this includes the risk of sedation, dissociation, and potential for abuse.

You must check the specific payer's guidelines for medical services.