G3002 Description, Billing Rules, & Use Cases

To compliantly report G3002, providers must deliver a qualifying 30 minutes of Chronic Pain Management (CPM) services during a single calendar month. These services must be delivered in-person by a physician or qualified health care professional (QHP) and are subject to specific clinical, time, and documentation requirements.

Patient Eligibility Criteria

G3002 may only be billed for patients with a chronic pain diagnosis:

• Pain must persist for ≥3 months
• Must cause significant functional impairment or require ongoing care
• A documented pain management plan must be active or initiated

There is no frequency limitation beyond the one-unit-per-month restriction, and services may continue indefinitely if medically necessary.

Who May Bill G3002

Only physicians or QHPs (e.g., NP, PA, CNS) may bill G3002:

• Must perform services personally (no incident-to or general supervision)
• Must be enrolled in Medicare and meet scope-of-practice guidelines
• May be performed in various settings: office, outpatient clinic, FQHC, RHC

Service Requirements

G3002 may be billed once per month per patient when all the following are met:

• At least 30 minutes of personally performed CPM services
  • Time must be documented in the patient chart
  • Multiple shorter visits may be aggregated across the month
• Pain assessment with validated tool
  • Examples: Numeric Pain Rating Scale, Brief Pain Inventory
  • Assessment must be clearly documented
• Person-centered care plan created or updated
  • Plan must include pain etiology, treatment goals, and interventions
  • Document any medication changes or referrals to ancillary care
• Behavioral and/or functional care coordination
  • Coordination with mental health, rehab, or primary care
  • Must be relevant to chronic pain management
• Crisis support and safety planning (if applicable)
  • For patients at risk of pain-related emergencies
  • Document interventions, referrals, or emergency planning

G3002 Billing Documentation Checklist

To bill G3002 compliantly, the following elements must be documented in the patient’s medical record for the calendar month:

• Chronic pain diagnosis and duration:
  • Condition causing pain must be clearly documented
  • Pain must be noted as persisting ≥3 months or recurring regularly
  • Functional impairment or clinical significance described
• Total time spent: ≥30 minutes:
  • Services must be personally provided by a physician or QHP
  • May be delivered in one or multiple visits within the same month
  • Cumulative time must be clearly documented (e.g., 15 min + 15 min = 30 min)
• Validated pain assessment tool used:
  • Examples: Numeric Pain Rating Scale, PEG-3, Brief Pain Inventory
  • Tool results and provider interpretation included in note
• Person-centered pain care plan created or updated:
  • Must include:
    • Diagnosis and suspected cause
    • Goals for pain reduction and function
    • Planned interventions (medications, PT/OT, behavior therapy, etc.)
  • Plan must be shared with patient or caregiver
• Medication management and review (if applicable):
  • Documentation of prescribed medications (opioids, NSAIDs, adjuvants, etc.)
  • Risk/benefit considerations and side effect review
  • Adjustment or refill activity noted if performed
• Coordination of care or referrals:
  • Communication with:
    • Mental health providers
    • Physical or occupational therapists
    • Community-based pain programs
  • Any care transitions, specialist consults, or support services initiated
• Crisis support (if needed):
  • Screening for suicide risk, opioid misuse, or acute flare-ups
  • Safety planning and emergency referrals documented
• Consent to receive CPM services:
  • Signed or verbal consent to initiate the monthly CPM process
  • Consent must be documented at the outset and retained in record