Key Points
- The Physician Fee Schedule Final Rule established a new G-code, HCPCS G0136, for administering a standardized, evidence-based SDOH risk assessment.
- HCPCS — produced by the Centers for Medicare and Medicaid Services — is a collection of standardized codes that represent medical procedures, supplies, products, and services.
- Any SDOH need identified through the risk assessment (HCPCS code G0136) must be documented in the patient’s medical record.
- The assessment can take 5 to 15 minutes and can't be performed more than once every 6 months.
FIM Opportunities
The social determinants of health (SDOH) risk assessment is intended to be used when a practitioner has reason to believe there are unmet SDOH needs that could interfere with the practitioner's diagnosis and treatment of a condition or illness.
Healthcare Common Procedure Coding System (HCPCS) code G0136 is not designed for routine screening. Instead, it is an assessment of one or more known or suspected SDOH needs that may interfere with the practitioners' diagnosis or treatment of the patient.
The SDOH risk assessment may identify nutrition and food security needs that could benefit from Food Is Medicine interventions.
