Question: Do I need specific consent for G0537 ASCVD risk assessment?
First: the two code descriptions:
G0537 Administration of a standardized, evidence-based Atherosclerotic Cardiovascular Disease [ASCVD] Risk Assessment for patients with ASCVD risk factors, 5-15 minutes, not more often than every 12 months per practitioner.
G0538 Atherosclerotic Cardiovascular Disease [ASCVD] risk management services; with the following required elements: patient is without a current diagnosis of ASCVD, but is determined to be at intermediate, medium, or high risk for CVD as previously determined by the ASCVD risk assessment; ASCVD-Specific care plan established, implemented, revised, or monitored that addresses risk factors and risk enhancers and must incorporate shared decision-making between the practitioner and the patient; clinical staff time directed by physician or other qualified health care professional; per calendar month.
Answer: G0537 is an in-person service for administration risk assessment tool. It is performed with an office visit. The 2025 Final Rule didn’t mention consent for this service. It does not require specific consent.
G0538 is a non-face-to-face care management service. It does require specific consent. In their 2025 Final Rule, CMS was very clear that it requires verbal or written consent, and that the consent is documented in the medical record. Patients need to be informed that the service has the potential for a patient due amount.
Two excerpts from the 2025 Final Rule:
“We proposed that patient consent must be obtained before starting ASCVD risk management services. Like other care management services, ASCVD risk management services will typically be provided by clinical staff outside of face-to-face patient visits. Consent can be written or verbal and must be documented in the medical record. Consent should also include informing the patient about these services, as well as potentially applicable Medicare cost sharing.”
“We would like to remind practitioners that the patient consent requirement for this service includes informing the patient about potentially applicable Medicare cost sharing.”
Based on this, you do not need specific consent for performing G0537, but do need specific verbal or written consent documented in the medical record when providing services reported with code G0538. And, the consent must include informing the patient of cost-sharing.