Managing complex or suspected infectious conditions requires providers with specialized training and expertise in infectious diseases. The G0545 add-on billing code, introduced by the Centers for Medicare & Medicaid Services in 2024 and implemented in 2025, was a long-overdue step toward acknowledging this reality.
This code, the first specifically designed for the ID specialty, reflects the additional complexity and intensity of hospital inpatient or observation evaluation and management services specifically related to ID. In this installment of the Coding Corner, several IDSA members share their experiences using the new add-on code.
Judy Guzman-Cottrill, DO, FIDSA
I asked my pediatric ID division’s coding/billing team to evaluate the effect of adding a dotphrase to our inpatient note EPIC template (specifically to use the G0545 code for all inpatient encounters). I should note that we are a pretty small division with no ID fellowship program — that’s how small we are!
The dotphrase at the end of every note is this: “Infection control recommendation for this patient to reduce the risk of disease transmission: *** ” (Note: We type in “standard precautions” if the patient is not in isolation precautions).
Our coding/billing expert determined that 100% of our inpatient notes have the documentation needed to meet the G0545 code (and our coders are correctly billing for it). Our division charged a total of $219,000 for the G0545 code in 2025.
Our division’s payments generated by the G0545 code was $70,554 in 2025 (the amount of money actually received by insurers). As you’d expect, some insurers are better than others when it comes to actual payments received.
In summary, adding one line to our inpatient notes about infection prevention generated an additional $70,000 last year.
Ronald Devine, MD, FIDSA
Practice overview
A 15-physician private practice single specialty infectious diseases group serving five hospitals
E/M visits
Both inpatient and outpatient E/M visits are performed with an average per physician providing 68.66% of E/M visits as inpatient visits with range of 48.89% to 85.60%.
G0545 impact on revenue, March 2025 through February 2026
G0545 has provided a great increase in revenue over the baseline E/M visit revenue. The average increase per physician above inpatient E/M visits was 26.54% with a range of 20.32% to 31.90%. When compared to total E/M revenue, G0545 provided, per physician, an average increase of 16.26% with a range from 9.60% to 24.56% of total E/M visit revenue.
G0545 payor performance
Medicare, including most Medicare Advantage plans, and most commercial payors consistently reimbursed G0545. Medicaid and most worker’s compensation insurances did not reimburse G0545.
In summary, G0545 has provided a high impact on total revenue with an average increase per physician of 16.26% over their total E/M revenue.
Aleena Zia, MBBS
I’m on an RVU-incentivized model in which we have a target set for six months to maintain our base salary. If you exceed it, you get a bonus based on the excess RVUs billed. Then they recalculate your base based on what you billed and set a new target for RVUs, and so on.
I started billing G0545 when it became available for some patients who had Medicare starting in January 2025. After attending the billing session at IDWeek that year, I started billing the code for every patient I saw after running it by our billers who confirmed that some private insurances were indeed reimbursing for it, and so I should just bill, and they could adjust later.
Based on that, my average billing quarter by quarter went up by about 200 RVU, or about 10%-15%, which has resulted in two bonuses and a raise. I didn’t work more, I just billed better.
Anonymous
I work at a large academic medical center with 25 infectious diseases faculty covering six busy inpatient consult services. We’ve seen strong adoption of G0545 since it was first introduced, with most faculty using it for the majority of inpatient visits.
In 2025, the use of G0545 resulted in about $45,000 per month of increased revenue for our division. Our individual compensation is determined by a base salary plus a bonus linked to wRVU productivity, and several faculty had significant increases in their bonuses in 2025, most likely due to productivity from G0545.
So overall, G0545 has had an excellent impact on our division revenue and individual ID physicians’ compensation.
Visit IDSA’s Coding and Payment webpage for more information about how to use the G0545 add-on code, including Q&As, a webinar recording, an infographic checklist and more.
The Coding Corner updates IDSA members about coding and billing issues. If you would like to ask a question for the Coding Corner, or if you have a general coding and billing question, please visit the Coding and Payment page and click on the yellow “Ask the Coder” button (member login required to submit a question).
