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G0296 HCPCS Code: Lung Cancer Screening Counseling

Last Updated: May 10, 2026

Before a Medicare patient can undergo a Low Dose Computed Tomography (LDCT) lung cancer screening, they must have a Shared Decision Making (SDM) visit. This visit is billed using G0296 ↗.

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2026 Medicare National Fee (G0296): Non-Facility (Office): $34.04 · Facility (Hospital): $25.10

Eligibility for G0296

Medicare covers this visit if the patient meets all of these criteria:

  • Age 50 to 77 years.
  • Asymptomatic (no signs or symptoms of lung cancer).
  • Tobacco smoking history of at least 20 pack-years.
  • Current smoker or one who has quit within the last 15 years.

Medical Necessity Documentation

Verify Medical Necessity

Don't risk a denial. See if your ICD-10 code is on the approved Medicare LCD list.

You must document the use of a decision aid, counseling on the benefits and harms of LDCT, counseling on adherence to annual screening, and counseling on smoking cessation. Use ICD-10 code Z87.891 ↗ (Personal history of nicotine dependence) or F17.210 ↗ (Nicotine dependence, cigarettes, uncomplicated).

NCCI Edits

G0296 is typically billed on its own, but if performed during an AWV or standard E/M, proper modifier usage (Modifier 25) is required.

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