HCPCS Code G0444

Quick Reference: HCPCS G0444

• Definition: Annual depression screening for Medicare beneficiaries, typically taking 5–15 minutes to administer a standardized questionnaire and review results.
• Frequency: Once per year (every 12 months). Only one screening is covered in a 12-month period, and 11 full months must pass between screenings. (Example: screening in Jan 2025 → next eligible in Jan 2026.)
• Eligibility: All Medicare Part B patients (no specific risk factors required). Screening must occur in a primary care setting with “staff-assisted” support for follow-up care. Clinical staff (e.g., nurse, MA) can administer the tool and advise the clinician of results under appropriate supervision.
• Allowed Settings: Primary care offices and clinics, certain outpatient hospital clinics, public health clinics, and via telehealth when payer rules are met. Not covered in ED, inpatient, or other non-primary care settings as a separately payable preventive screening.
• Billing Restrictions: Do not report G0444 on the same day as a “Welcome to Medicare” exam (G0402) or initial Annual Wellness Visit (AWV, G0438) because depression risk assessment is treated as included/bundled in those services. It may be billed with a subsequent AWV (G0439) and can be billed with a problem-oriented E/M when documentation supports a separate screening service (typically using modifier 25 on the E/M).
• Patient Cost: Covered at 100% by Medicare (no copay or deductible applies) as a preventive service when billed as a screening and processed under preventive rules. If an E/M visit is billed concurrently, the E/M remains subject to normal Medicare cost-sharing.

HCPCS G0444 is Medicare’s code for an annual adult depression screening performed with a standardized, validated instrument. Introduced as a preventive benefit, it supports systematic screening in routine care so that depression can be identified early and routed to appropriate evaluation and treatment. The service generally involves administering a brief questionnaire (commonly PHQ-2 or PHQ-9, but not limited to those), scoring it, and communicating the result to the clinician who is responsible for follow-up decisions.

It is important to separate what G0444 is from what it is not. G0444 pays for screening—a structured check for depressive symptoms in an eligible patient—and does not pay for psychotherapy, psychiatric diagnostic evaluation, medication management, or counseling. If the screen is positive and the clinician evaluates symptoms, diagnoses depression, addresses suicidality, starts medication, or provides counseling, those activities belong in a separately billable service such as a problem-oriented E/M (or other behavioral health services, when applicable) and should be documented and coded separately.

Medicare’s policy design also ties this screening benefit to a primary care context with a capacity for follow-up. In other words, Medicare expects that a positive screen triggers a pathway: discussion of results, safety assessment when needed, referral options, and documented next steps. Several payer-facing guidance documents emphasize workflow expectations for screening and follow-up supports, including that staff may assist and that the setting must be one where follow-up care can be coordinated. This guide consolidates the practical coverage criteria, documentation standards, and billing rules most relevant in 2025–2026.

1. Medicare Coverage Criteria & Frequency

Eligibility is broad. Medicare covers annual depression screening for Part B beneficiaries as a preventive service. A specific risk factor is not required: the benefit is structured to support population-level screening rather than restricting to only high-risk groups. In practice, many offices operationalize G0444 alongside other preventive services and quality programs, using standardized templates or intake workflows.

Frequency is strict. Medicare pays for one G0444 screening per beneficiary per 12 months, and guidance commonly describes the rule as requiring at least 11 full months between screenings. This is not the same as “once per calendar year.” For compliance, treat it as “12-month periodicity” and track last billed date-of-service, not the year number. A useful operational approach is to allow scheduling in the same month of the following year only when the required months have elapsed, mirroring the “11 full months” interpretation commonly described in Medicare-facing materials.

Time is described, but not usually the payment driver. The descriptor references “5 to 15 minutes,” signaling that the service is brief and standardized. Medicare guidance and physician-facing explanations commonly emphasize that the screening is short, and that the core is use of a validated tool rather than meticulous minute-by-minute accounting. From an audit standpoint, the defensible documentation is “tool used + score/result + follow-up plan if positive,” not necessarily exact minutes. However, if you bill G0444 on the same day as a problem-oriented E/M, noting that staff administered/scored the instrument and the clinician reviewed results can help demonstrate a discrete service separate from the E/M work.

Screening vs. monitoring. A frequent compliance pitfall is using G0444 as if it were a symptom severity tracker for a patient already diagnosed and being treated for depression. While practices may use PHQ-9 serially to monitor treatment response, that monitoring is generally part of ongoing management and typically belongs under the E/M (or applicable behavioral health management codes), not under the annual preventive screening code. Medicare-facing discussions of the benefit characterize it as “screening” intended to detect possible depression and trigger evaluation and follow-up supports, not to pay repeatedly for monitoring within a treatment plan.

Recommended workflow on a positive screen. While the billing code is limited to screening, patient safety considerations are central. If a screening instrument suggests suicidality or severe symptoms, clinical response should be documented: assessment, safety planning, crisis resources, referral, and timely follow-up. Practice guidance documents and payer education resources frequently emphasize that primary care settings must have mechanisms for follow-up and coordination when screening identifies risk.

2. Primary Care Setting & Eligible Providers

Primary care setting requirement. Medicare expects the screening to occur in a primary care environment with staff-assisted supports for follow-up care, which is why ED and inpatient settings are not typically appropriate for separately billing G0444 as a preventive service. Primary care settings include physician offices, outpatient clinics, and similar environments where longitudinal care and referrals are managed. In these environments, the clinician who receives results can reasonably coordinate next steps.

Staff-assisted supports—what this means in practice. “Staff-assisted” does not require an embedded psychiatrist. It generally means the practice has staff processes to administer the instrument, ensure results reach the clinician, and help coordinate follow-up when needed (referrals, scheduling, patient education, connecting to behavioral health services). Medicare-facing fact sheets describe staff involvement and the expectation that results are communicated to the clinician responsible for care decisions.

Eligible providers and “incident-to” workflow. Physicians and qualified non-physician practitioners can bill G0444 when requirements are met. Common real-world workflow: clinical staff (MA, nurse) administers and scores a tool; the clinician reviews the result, documents the interpretation and any plan, and bills the service. Medicare guidance materials and professional summaries frequently describe this shared workflow, emphasizing that staff may administer but clinical oversight and the ability to arrange follow-up supports are essential.

Telehealth considerations. Many practices now perform depression screening via telehealth, particularly as intake questionnaires can be completed through patient portals or during video visits. Payer guidance and provider resources recognize telehealth as an allowable modality in appropriate outpatient settings. Still, the core requirement remains: the encounter must occur in a setting and workflow with follow-up support, and the screening must be performed with a standardized instrument and documented. For telehealth, ensure your claim uses correct POS and telehealth modifiers per your Medicare Administrative Contractor or payer instructions and confirm the patient’s eligibility timing (12-month frequency). Telehealth does not relax the frequency rule.

Where not to bill it. If a hospital uses depression questions as part of admission screening or nursing protocols, that activity typically does not qualify as separately billable preventive screening under G0444. Medicare-facing preventive service guidance often distinguishes routine institutional protocols from separately payable preventive services, and the primary care setting requirement is a key boundary.

3. Documentation Requirements (Screening Tools & Time)

Use a standardized instrument. Medicare expects the depression screening to be performed using a standardized, validated tool. In practice, commonly used instruments include PHQ-2, PHQ-9, Geriatric Depression Scale (GDS), and other validated tools appropriate to the patient population. Provider education materials emphasize that the documentation should reflect the tool and the result, not merely a statement that “screening performed”.

Minimum documentation elements. To support G0444, include:

• Instrument used (e.g., “PHQ-9 administered”).
• Result (score and/or interpretation such as negative/positive; score is preferred).
• Clinician acknowledgment (reviewed result and made/confirmed a plan).
• Follow-up plan if positive (evaluation/referral/safety resources as appropriate).

Time documentation—optional, but can be helpful. The descriptor references 5–15 minutes, and many clinician resources note that exact time tracking is not typically required for Medicare payment. However, when the screening is billed on the same date as a problem-oriented E/M, some practices choose to note approximate time or explicitly state that staff administered/scored the tool and the clinician reviewed results. This can help demonstrate a discrete preventive screening service distinct from the E/M management.

Diagnosis coding for the screening line. A common diagnosis for the screening service is Z13.31 (Encounter for screening for depression). Using a screening diagnosis helps Medicare systems recognize the service as preventive (supporting the “no cost-sharing” preventive processing) and aligns with preventive-service intent described in educational resources. If the screen is positive and the clinician evaluates and diagnoses depression, you may also document and code a depression diagnosis for the E/M service; however, keep the screening line tied to the screening diagnosis to preserve preventive classification.

Positive screens: separate the screening from the evaluation. Documentation should show the transition from “screening result” to “clinical evaluation and management.” This matters because G0444 pays only for the screening step. If you bill an E/M on the same day, the E/M documentation should include the clinical assessment, differential, risk evaluation, and treatment plan. Many resources describing depression screening emphasize that a positive screen warrants further evaluation, which is distinct from the screening itself.

Practical template language (examples).

• Negative screen: “Annual depression screening performed using PHQ-9. Score 3 (negative). Reviewed with patient; no intervention indicated.”
• Positive screen: “Depression screening performed using PHQ-9. Score 15 (positive). Reviewed result. Further evaluation performed today (see E/M). Safety assessment completed; patient denies active plan. Discussed treatment options and referral.”

Audit resilience. The fastest way to fail a G0444 audit is to omit the tool name and score/result. The next most common issue is billing the code on a date when the patient had already received the service within the last 12 months, which is a frequency denial. Operationally, track last screening date and configure EHR alerts to prevent accidental early repeats.

4. Billing Rules and Same-Day Services

Standalone billing. When G0444 is billed by itself, report it with the screening diagnosis (commonly Z13.31). As a preventive service, it is typically processed with no patient cost-sharing when billed and adjudicated correctly.

Do not bill with “Welcome to Medicare” (G0402) or initial AWV (G0438). Depression risk assessment is treated as included in those preventive visits; payer-facing guidance and coding discussions frequently reference denials when G0444 is billed on the same day as G0438, reflecting bundling logic. Operationally, if you perform a structured questionnaire during an initial AWV/IPPE, capture it in documentation for clinical completeness, but do not expect separate payment under G0444 on that date.

Subsequent AWV (G0439): often payable with G0444. In contrast, subsequent AWVs do not uniformly treat depression screening as a required included element, and payer guidance commonly describes that G0444 can be billed in addition to G0439 when the service is performed and frequency rules are met. This is a common revenue-safe place to incorporate screening.

Problem-oriented E/M on the same date: use modifier 25 on the E/M when appropriate. Many practices screen during chronic care visits. In that scenario, the screening remains preventive and separately payable, but the E/M must be clearly significant and separately identifiable. Common operational approach: bill G0444 on its own line with Z13.31, and bill the E/M with modifier 25. Documentation should show both the medical problem work and the discrete screening activity.

Cost-sharing communication. Patients often assume the entire visit is “free” when screening is performed. Clarify that the screening line is preventive and covered without cost-sharing, but any concurrent problem-oriented E/M may still create coinsurance. This aligns with Medicare preventive processing described in provider guidance.

Common denial patterns and fixes.

• Frequency denial: screening billed too soon. Fix: verify last date-of-service, resubmit only if the prior screening was not actually performed/paid or if dates were mis-entered; otherwise, do not expect payment.
• Bundled with G0438/G0402: fix is usually “do not bill G0444” on that date; capture in AWV/IPPE documentation instead.
• Denied as included in E/M: use modifier 25 correctly on the E/M and ensure documentation supports separate screening; confirm your MAC/payer’s edit logic.

flowchart TD
    A[Patient presents for visit] --> B{Visit type?}
    B -->|IPPE G0402 or Initial AWV G0438| C[Do NOT bill G0444 separately]
    C --> C1[Document screening within AWV/IPPE note]
    B -->|Subsequent AWV G0439| D[Bill G0439 + G0444]
    D --> D1[Link G0444 to Z13.31]
    B -->|Problem-oriented E/M| E{Annual screening due?}
    E -->|No, less than 11 months| F[Bill E/M only]
    E -->|Yes, 11+ months since last| G[Bill E/M with modifier 25 + G0444]
    G --> G1[Link G0444 to Z13.31]
    B -->|Standalone screening| H[Bill G0444 alone]
    H --> H1[Link to Z13.31]
    G1 --> I{Screen result?}
    D1 --> I
    H1 --> I
    I -->|Negative| J[Document tool + score + no intervention needed]
    I -->|Positive| K[Document tool + score + follow-up plan]
    K --> L[Separate E/M for evaluation/treatment if needed]

5. Non-Medicare Coding (96127 vs G0444)

Medicare uses G0444; non-Medicare often uses CPT screening codes. Commercial insurers and many Medicaid programs typically do not use Medicare G-codes as their primary payment mechanism for depression screening. Provider resources discussing depression screening and coding often direct non-Medicare billing to CPT codes such as 96127 or 96160, depending on payer policy and the nature of the instrument.

CPT 96127 (brief emotional/behavioral assessment). This code is widely used for standardized behavioral health instruments such as PHQ-9, GAD-7, and similar tools, often billed per instrument. Commercial payer policies vary: some reimburse it separately, others bundle it into preventive services or E/M. If a payer provides guidance on depression screening tools and coding, follow that payer’s direction and document instrument name and score.

CPT 96160 (patient-focused health risk assessment). Some payers classify certain questionnaires under health risk assessment rather than behavioral assessment. In practice, selection between 96127 and 96160 is payer-dependent and driven by the payer’s coding rules. Provider-facing resources sometimes discuss both codes as options depending on context and plan requirements.

Medicare Advantage (Part C). Medicare Advantage plans generally follow Medicare preventive benefits and often accept G0444 consistent with CMS rules. Still, MA plans may have additional claims-processing rules (telehealth reporting, POS expectations), so confirm plan-specific requirements while retaining Medicare’s core frequency and setting principles.

Avoid mixing quality reporting codes with payment codes. Some practices see additional “G-codes” in EHR templates for quality measures documenting negative/positive depression screen outcomes. Those are not payment substitutes for G0444. Keep your billing line for payment as G0444 (Medicare) or the appropriate CPT code (non-Medicare), and treat quality-reporting lines as separate reporting when required by a program.

6. Example Clinical Scenarios

Scenario 1: Initial Preventive Visit – Screening Included

Visit: A 65-year-old new Medicare enrollee presents for their “Welcome to Medicare” initial preventive exam (IPPE, code G0402). The clinician completes the required preventive elements, including review of depression risk questions. The patient completes a brief instrument and the result is negative.

Coding: Bill G0402 only. Do not bill G0444 on the same day.

Rationale: Coding and payer guidance treat depression risk assessment/screening as included in the IPPE/initial AWV structure, and billing G0444 on the same date commonly results in denial as bundled/incompatible. Document the screening clinically within the IPPE note, but do not bill it separately.

Scenario 2: Subsequent AWV with Screening Add-On

Visit: A 76-year-old patient presents for a subsequent Annual Wellness Visit (G0439). She is due for an annual depression screening based on last screening date. Staff administers PHQ-9; score is 5 (minimal symptoms). Clinician reviews result; no further evaluation is needed.

Coding: Bill G0439 and G0444. Link G0444 to Z13.31. No modifier is required solely to pair G0439 with G0444 in typical Medicare workflows when both services are distinct and documented.

Rationale: Subsequent AWVs can support separately reported depression screening when the screening is performed and the patient meets the annual frequency requirement. Documentation should clearly show the tool and score.

Scenario 3: Routine Office Visit with Positive Screen

Visit: A 70-year-old with diabetes presents for chronic disease follow-up. During intake, staff performs the annual depression screening because it is due. PHQ-9 score is 15 (positive). The clinician addresses diabetes and conducts additional evaluation regarding mood symptoms, safety, and treatment options. Medication is started and follow-up is scheduled.

Coding: Bill the appropriate E/M (e.g., 99213) with modifier 25 and bill G0444 separately. Link G0444 to Z13.31. Link the E/M to the chronic condition diagnosis and, if diagnosed/managed, a depression diagnosis consistent with your assessment and documentation.

Rationale: The screening itself is a preventive service; the evaluation and management after a positive screen is separate clinical work and belongs under the E/M. Modifier 25 supports that the E/M was significant and separately identifiable from the preventive screening service. Document the tool, score, clinician review, and follow-up supports/referrals as needed.

Scenario 4: Telehealth Annual Screening (Due, Negative)

Visit: A Medicare beneficiary completes an annual telehealth check-in with their primary care clinician. The practice sends the PHQ-9 through a secure patient portal or administers it during the video visit. The score is low/negative, and the clinician documents the result and confirms no need for further work-up.

Coding: Bill G0444 when payer telehealth requirements are met and the setting qualifies as primary care with follow-up supports. Ensure your claim reflects correct telehealth reporting rules for your payer/MAC and the annual frequency is met.

Rationale: Telehealth can be an operationally sound way to deliver preventive screening when the practice retains responsibility for follow-up and documentation remains complete (instrument + result + review).

Scenario 5: Denial for Frequency or Bundling—Corrective Workflow

Situation: A practice bills G0444 and receives a denial. Two common causes: (1) the patient had already received G0444 within the last 12 months (frequency), or (2) the screening was billed on the same day as initial AWV (G0438) and denied as bundled.

Action: For frequency denials, verify the last paid screening date and adjust recall systems so staff can see eligibility before administering the annual screen. For bundling denials with G0438 or G0402, stop billing G0444 on those dates and document screening within the AWV/IPPE encounter instead.

Rationale: Most denials are preventable with eligibility tracking and correct awareness of same-day bundling logic discussed in Medicare-facing guidance and coding forums.