G0447
Behavior counsel obesity 15m
Face-to-face behavioral counseling for obesity, 15 minutes. CMS 2026 wRVU 0.45. Medicare preventive benefit covering intensive behavioral therapy (IBT) for obesity, up to 22 sessions in a 12-month period. Requires patient BMI 30 or greater documented in the chart on the date of service.
When to use it
Use G0447 for Medicare-covered intensive behavioral therapy for obesity in a primary-care setting. Eligibility requires BMI 30 or greater documented on or near the date of service.
Full guidance
The CMS-defined cadence is weekly for the first month, biweekly for months 2 to 6, then monthly for months 7 to 12 if the patient has lost at least 6.6 pounds during the first 6 months ("6.6-pound rule"). Total session cap: 22 sessions per 12-month period. The 5-A framework (Assess, Advise, Agree, Assist, Arrange) provides the documentation backbone. The 12-month period restarts when the patient achieves a 5-percent weight loss from baseline.
Documentation checklist
- ✓BMI 30 or greater documented at or within a reasonable timeframe of the visit (CMS does not specify exact, but same-day BMI is best practice).
- ✓15 minutes of face-to-face counseling with the patient.
- ✓5-A model content documented: Assess (current weight, eating, activity), Advise (the clinical recommendation), Agree (mutual goal-setting), Assist (specific behavioral interventions, referrals), Arrange (follow-up plan).
- ✓Cumulative session count within the 12-month period, ensuring eligibility for continued visits.
- ✓After 6 months, document at least 6.6-pound weight loss for continued coverage beyond session 14.
- ✓Performed in a primary-care setting by the patient's primary-care clinician or qualifying NPP.
Common pitfalls
- !BMI under 30 on the date of service. Medicare denies if BMI eligibility is not met. Document the most recent height and weight to compute BMI.
- !Exceeding 22 sessions in a 12-month period without 5-percent weight loss reset. Subsequent sessions are denied.
- !Failing the 6.6-pound rule at the 6-month mark. Visits beyond session 14 in the same period require documented progress.
- !Billed by a non-primary-care clinician. Medicare restricts G0447 to primary care; specialty-only encounters do not qualify.
- !Less than 15 minutes face-to-face. The 15-minute threshold is firm.
- !Performed without 5-A documentation. Templates that auto-populate "obesity counseling" without the structural elements fail audit.
Payer notes
Medicare covers G0447 with no patient cost share for up to 22 sessions per 12-month period. Medicare Advantage plans typically follow. Commercial payer coverage varies; many do not specifically recognize G0447 and instead cover obesity counseling under 99401 to 99404 (preventive medicine counseling individual) or via 99214 with appropriate diagnosis. The 22-session structure is unique to Medicare; commercial plans usually have a different annual cap.