Don't forget about a key change to a Medicare-covered HCPCS code that providers reported hundreds of thousands of times in its debut year. As of Jan. 1, code G0136 now covers physical activity and nutrition assessments, not social determinants of health (SDOH).
In 2024, the year that the first, SDOH-based version of the code debuted, providers reported the service more than 235,000 times, gaining $2.2 million in reimbursement. The lion's share of reporting came from family practice, internal medicine and nurse practitioner specialties. Medicare claims figures for calendar year 2025 are still pending, so it remains to be seen whether the utilization trends picked up or otherwise changed.
However, providers should take note of the code's new descriptor, effective in 2026: "Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months."
As Part B News previously reported, CMS expects that providers who report the code would “at minimum” refer the patient to relevant resources “and take into account the results of the assessment in their medical decision-making, or diagnosis and treatment plan for the visit.”
In the updated E/M Services booklet, CMS clarifies that providers can perform the physical activity and nutrition assessment during: E/M visits, annual wellness visits (AWV) and behavioral health office visits.
Typically, the provider would perform both a physical activity and a nutrition risk assessment when they report the code, but CMS will allow only one assessment when it is clinically appropriate, according to the 2026 fee schedule. “For example, if a beneficiary has recently started a new diet but their physical activity levels have not been assessed, only a physical activity risk assessment may be reasonable and necessary,” CMS explained.
Certain specialties may want to pay extra attention. The following charts shows the top 10 specialties reporting the G0136 service in 2024, when it remained SDOH-focused:
| Family practice |
$874,156 |
| Internal medicine |
$752,013 |
| Nurse practitioner |
$328,814 |
| Physician assistant |
$74,299 |
| General practice |
$20,556 |
| Hospitalist |
$15,830 |
| Hematology/oncology |
$20,863 |
| Geriatric medicine |
$9,866 |
| Cardiology |
$7,512 |
| Psychiatry |
$5,022 |
Get timely news, expert insights and more — subscribe to
Part B News today.