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G3003
Description, Billing Rules, and Use Cases

G3003 is a time-based add-on code used to report each additional 15 minutes of personally delivered Chronic Pain Management (CPM) services in a calendar month. It must be billed in conjunction with G3002, which covers the initial 30 minutes.

 

Services must be personally provided by a physician or qualified health care professional (QHP), and must support a comprehensive, person-centered chronic pain care plan.

What is HCPCS Code G3003?

HCPCS code G3003 represents an incremental extension of monthly Chronic Pain Management services under Medicare. It is billed in 15-minute units following the first 30 minutes reported with G3002. The code supports physicians and QHPs in managing chronic pain through follow-up assessment, behavioral health coordination, medication titration, and other hands-on interventions that continue beyond the initial care session.

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This code may only be used when:

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  • The patient has a diagnosed chronic pain condition

  • The G3002 base code has already been billed for the month

  • Additional time is personally provided by the billing provider

  • Full 15-minute increments beyond the base 30 minutes are reached

 

G3003 is not a stand-alone code and will be rejected if submitted without G3002 for the same calendar month.

G3003 Billing Requirements and Eligibility

To compliantly report G3003, providers must first bill a qualifying 30-minute Chronic Pain Management (CPM) session using G3002 within the same calendar month. G3003 may then be used to report each additional 15-minute increment of CPM services personally delivered by a physician or qualified health care professional (QHP), with strict requirements for time tracking, care continuity, and documentation.

Patient Eligibility Criteria

  • Must have a documented chronic pain condition (e.g., low back pain, neuropathy, arthritis)

  • Must be under active management by a physician or QHP for pain-related care

  • Should have received at least 30 minutes of CPM services (reported under G3002) earlier in the calendar month

Time and Service Threshold

  • G3003 covers each additional 15 minutes of CPM services personally delivered after the base 30 minutes

  • Minimum of 15 full minutes must be completed per G3003 unit

  • Services must be personally provided by a physician or QHP — time by other team members does not qualify

Documentation Requirements

The clinical record must reflect:

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  • Total cumulative CPM time for the month

  • Breakdown of services delivered during the additional 15-minute unit(s)

  • Provider involvement and roles

  • Updated patient status and care goals

  • Integration of services into the overall CPM care plan

Billing Limits and Combinations

  • Must be billed with G3002 — cannot stand alone

  • Multiple G3003 units may be reported if sufficient time is met (i.e., 45 minutes = G3002 + 1×G3003)

  • Do not round up for time short of a full 15-minute unit

  • May be reported with other care coordination codes if criteria are separately fulfilled

G3003 Billing Documentation Checklist

To compliantly bill G3003, the following must be clearly documented in the patient’s chart:

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  • Confirmation that G3002 has been billed for the same calendar month

    • G3003 cannot be billed independently

  • Total cumulative time spent delivering CPM services

    • Must exceed the 30-minute threshold covered by G3002

    • Additional 15-minute unit(s) must be complete — do not round

  • Description of services provided during the extended time, including:

    • Ongoing pain assessment and treatment updates

    • Medication management or dose titration

    • Behavioral health coordination or counseling

    • Care plan modification or goal adjustment

    • Communication with specialists or caregivers

  • Provider credentials and involvement

    • Services must be personally delivered by a physician or QHP

    • No substitution with clinical staff time

  • Patient engagement and care planning continuity

    • Evidence that services build on prior care delivered under G3002

    • Alignment with the patient’s long-term pain management strategy

G3003 Time Thresholds and Code Combinations

To determine when G3003 may be billed, providers must calculate the total time spent delivering Chronic Pain Management (CPM) services during the month. G3002 must always be reported first for the initial 30 minutes. G3003 may then be billed for each additional 15-minute increment, but only after those minutes are fully reached.

 

Time must be tracked accurately and must reflect personally delivered services by a physician or QHP. Partial increments should not be rounded up.

Table showing billing scenarios for HCPCS G3003: report G3002 for the first 30 minutes of CPM services, then add one unit of G3003 for every full 15-minute increment beyond that, with all services personally provided by a physician or QHP.

Key Reminders:

  • G3002 must be billed first

  • Each G3003 unit = one full 15-minute block

  • Do not round — 44 minutes = G3002 only

  • Time from clinical staff or other team members does not qualify

  • Services must occur within the same calendar month

  • Additional units may be reported as long as thresholds are met

When to Use G3003:
Common Scenarios and Use Cases

G3003 is used to report each full 15-minute increment of Chronic Pain Management (CPM) services after the initial 30 minutes billed under G3002. All services must be personally provided by a physician or qualified health care professional (QHP), and may occur across multiple visits within the same calendar month.
 

  • Ongoing Opioid Monitoring for Chronic Joint Pain
    A primary care physician:

    • Assesses pain levels and recent adverse effects of opioid therapy

    • Reviews dosing and tapering strategy with patient

    • Updates care plan to add adjunct physical therapy
      Total provider time: 46 minutes
      Billing: G3002 + 2×G3003
       

  • Behavioral Health Coordination for Diabetic Neuropathy
    A nurse practitioner:

    • Conducts PHQ-9 and coordinates behavioral therapy referral

    • Provides medication review and side effect counseling

    • Engages in two follow-ups to adjust pain goal strategy
      Total provider time: 76 minutes
      Billing: G3002 + 3×G3003
       

  • Multidisciplinary Planning for Failed Back Surgery Syndrome (FBSS)
    A physician assistant:

    • Holds extended coordination calls with neurology and behavioral health

    • Revises patient’s long-term care plan with updated medication tracking

    • Provides education to patient and caregiver regarding symptom escalation
      Total provider time: 91 minutes
      Billing: G3002 + 4×G3003

Common G3003 Billing Mistakes
(and How to Avoid Them)

Because G3003 is a time-based add-on code, it’s especially vulnerable to denials due to incorrect stacking, incomplete documentation, or improper time attribution.
 

❌ Billing G3003 Without G3002
G3003 is an add-on code and cannot be billed unless G3002 has already been submitted for the same calendar month. Standalone use will be denied.


❌ Failing to Meet the Full 15-Minute Threshold
Each G3003 unit requires a complete 15-minute increment of personally provided time. For example, 43 minutes of total CPM time only qualifies for G3002 + one G3003, not two.


❌ Including Staff or Incident-To Time
Only time spent personally by a physician or QHP counts toward G3003. Time provided by nurses, MAs, or other staff — even under supervision — does not qualify.


❌ Rounding Up Incomplete Time Blocks
Do not round up partial 15-minute segments. G3003 is only payable when the full block is met. For instance, 59 minutes = G3002 + 1×G3003, not 2×G3003.


❌ Not Tying Services to a Documented CPM Plan
All billed time under G3003 must contribute to the active, person-centered CPM care plan. Services must be clearly related to the patient’s chronic pain goals and management strategy.

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