Screening / Counsel · CMS status A
G0538
Ascvd rsk mng clin stf pr mo
ASCVD risk management, clinical staff time per calendar month.
Work RVU
0.18
2026 Medicare pays
$17.03
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 0.18 + Practice 0.32 + Malpractice 0.01 = 0.51 total
Work (your effort)Practice expenseMalpractice
When to use it
Ongoing ASCVD risk management requiring clinical staff coordination, per calendar month.
Documentation checklist
- ✓Initial G0537 (annual risk assessment) on file.
- ✓Monthly clinical staff time for risk-factor management.
- ✓Care plan updates documented.
Common pitfalls
- !Cannot bill without prior G0537 baseline assessment.
- !Time must be tracked monthly.
Common ICD-10 pairings
I25.10Z13.6
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.