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Billing code

G520A — Diabetes monthly management – each additional month, 4 or more contacts

Diabetes insulin month, 4+ contacts

Bill G520 for a month after the G500 month with 4 or more 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.

Code

G520A

Description

Diabetes monthly management – each additional month, 4 or more 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

Monthly management of an insulin-treated diabetes patient, for each later month with 4 or more contacts that change insulin dose or frequency.

What it covers

Diabetes monthly management covers advice, direction or information to the patient, a relative, representative or caregiver, by telephone or otherwise, in which a change in insulin frequency or dose is started, for a patient on 2 or more daily insulin injections or an insulin pump. Each such exchange is a contact (J41).

It includes monitoring insulin therapy, adjusting insulin, related discussion, arranging related services and interpreting results. G500 is the starting month, G514 a later month with 1 to 3 contacts, and G520 a later month with 4 or more (J41, J42).

Billing rules

• Only the physician most responsible for the patient's diabetes care, or a physician substituting for them, may bill it (J42).
• You must make the clinical decisions personally; staff may pass them on to the patient (J42, J43).
• A contact on the same day as your consultation or assessment of the patient doesn't count (J42).
• Reviewing lab or patient-created reports, or giving results when no insulin change is needed, is not a contact (J42).
• Only one of G500, G514 and G520 per patient per physician per calendar month. If G514 and G520 are both claimed in a month, payment is adjusted to G520 (J42, J43).
• Record a dated summary of each contact in the chart (J42).

Often billed with

• K045 or K046 annual specialist diabetes management (A99, A100).

Related codes: G500, G514, K045, K046

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Endocrinology and Metabolism, page J42 (definition J41).

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