G30.1 coverage policies: Medicare and commercial payers

50 active Medicare policies list G30.1, and 1 commercial payer policy lists it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.

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Medicare policies listing G30.1

LCD · NOVITAS-JH-L34914

Assays for Vitamins and Metabolic Function

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L34914

Assays for Vitamins and Metabolic Function

JL · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L39266

Cognitive Assessment and Care Plan Service

JJ · Effective Aug 28, 2022

LCD · PALMETTO-JM-L39266

Cognitive Assessment and Care Plan Service

JM · Effective Aug 28, 2022

LCD · PALMETTO-JJ-L34417

CT of the Head

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34417

CT of the Head

JM · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L37638

Health and Behavior Assessment/Intervention

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37638

Health and Behavior Assessment/Intervention

JM · Effective Jan 29, 2018

LCD · NOVITAS-JH-L35049

Monitored Anesthesia Care

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35049

Monitored Anesthesia Care

Commercial payer policies listing G30.1

1 policy from 1 payer

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Ambetter

Ambetter policies listing G30.1, with the code’s status in each
Policy	Effective	Status of G30.1
Long Term Care PlacementPayerPolicy · AMBETTER-CP-MP-71	Not recorded	Covered