• HCPCS code G0136 for an assessment of patients a practitioner suspects may have difficulty with accessing treatment and following a treatment plan due to Social Determinants of Health (SDoH)

CMS established a standalone code G0136 (a HCPCS code) for the assessment of SDoH. They define SDoH into broad groups: “economic stability, education access and quality, neighborhood and built environment, and social and community context, which include factors like how soon, food and nutrition access, and transportation needs.” PFS Final Rule, 2025 Display Copy p 345. CodingIntel addressed the question of what conditions are included in SDoH in a recent Q&A.

G0136 defined as “Administration of a standardized, evidence-based Social Determinants of Health Risk Assessment, 5-15 minutes, not more often than every 6 months.” The risk assessment is in relation to the patient’s social risk factors that influence the diagnosis and treatment of medical conditions.  This is a service that can be performed in outpatient settings, with the exception of discharge visits, discussed below.