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The Centers for Medicare and Medicaid Services (CMS) have updated the CPT code for the Social Determinants of Health (SDoH) assessment for 2025.
An SDoH assessment is a valuable tool to help to identify known or suspected SDoH needs that may interfere with the diagnosis or treatment of a patient and can help lead to improved outcomes. They include factors like socioeconomic status, education, neighborhood and physical environment, employment, social supports, and access to healthcare. Assessing these factors can indicate the level of social risk and social need that create barriers for patients to receive timely, adequate care and achieve better health.
Social Determinants of Health CPT Code
The Social Determinants of Health assessment is billed with CPT code G0136.
In this video, we'll review the G0136 billing requirements and reimbursement rates. You'll learn about the SDoH assessment, who can administer it, and about the benefits of administering the assessment during an Annual Wellness Visit (AWV), as a Social Determinants of Health Assessment is completely covered for patients under Medicare Part B if done during an AWV. An SDoH assessment can be a great addition to the care coordination services that you offer.
Download a free SDoH guide to help you manage your program.
