Billing code
G514A — Diabetes Monthly Management - Each Additional Month, 1 To 3 Contacts
Diabetes insulin month, 1–3 contacts
Bill G514 for a month after the G500 month with 1 to 3 contacts that change insulin dose or frequency.
Watch for: Contacts on the same day as your visit don't count; only one of G500, G514 or G520 per month.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $10.60 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- G514A
- Description
- Diabetes Monthly Management - Each Additional Month, 1 To 3 Contacts
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2025
- Termination date
- No end date
Explanation
Updated October 26, 2026
Diabetes monthly management for an insulin-treated patient after the starting month, with 1 to 3 insulin-adjusting contacts in the month.
What it covers
G514 pays for each month of diabetes management after the G500 month in which there are 1 to 3 contacts that change the frequency or dose of insulin, for a patient on 2 or more daily insulin injections or an insulin pump (J41, J42).
A month with 4 or more contacts is G520 instead (J42).
Billing rules
- Only one of G500, G514 and G520 per patient per physician per calendar month (J42, J43).
- If G514 and G520 are both claimed for the same patient and month, payment is adjusted to G520 (J43).
- Payable only to the physician most responsible for the patient's diabetes care, or a physician substituting for that physician (J42).
- A contact is advice, by phone or otherwise, to the patient or caregiver in which a change in the frequency or dose of insulin is started, for a patient on 2 or more daily insulin injections or an insulin pump (J41).
- Reviewing lab or patient-created reports, or passing on results with no change in insulin frequency or dose, doesn't count (J42).
- A contact on the same day as your consultation or assessment of the patient doesn't count as a contact (J42).
- The clinical decision must be yours or the substitute's; staff may pass it on (J42, J43).
- A dated summary of each contact must be in the medical record (J42).
Often billed with
- A007 or another assessment for an in-person visit that month; a contact on the day of that visit doesn't count toward G514 (J42).
Related codes: G500, G520, A007
Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Endocrinology and Metabolism — Diabetes monthly management, pages J41–J43
APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing