G0463 - Visit to a hospital's outpatient clinic for medical evaluation and treatment

Healthcare Common Procedure Coding System

Last updated: 10/3/2025

What is a HCPCS Code?

HCPCS (Healthcare Common Procedure Coding System) codes are used to identify medical procedures, supplies, and services for billing purposes. These codes help standardize how healthcare services are reported and billed across different providers and insurance companies.

Detailed Description

This code represents a visit to a hospital's outpatient clinic where you receive medical care without being admitted as an inpatient. During this visit, a healthcare provider will assess your condition, review your symptoms, perform necessary examinations, and develop or adjust your treatment plan. This type of visit is for patients who need medical attention but don't require an overnight hospital stay. The visit may include consultation with specialists, diagnostic discussions, treatment planning, or follow-up care for ongoing conditions.

Additional Information

This is a general outpatient clinic visit code used by hospitals. The specific services provided, duration, and complexity of the visit may vary based on your individual medical needs and the type of clinic (such as cardiology, endocrinology, or general medicine). Always verify coverage with your insurance provider before the visit.

Category

Outpatient Services

Medical Specialty

General/Multi-specialty

Expected Costs

We expect this to normally be in the range of:

$150 - $500

This is an estimate based on typical billing patterns. Your actual cost may vary depending on your insurance coverage, provider location, and specific circumstances.

What's Required Before This

  • Physician referral may be required depending on insurance
  • Valid insurance authorization if required by plan
  • Appointment scheduling through hospital system

What to Expect After

  • Follow-up appointments as recommended by provider
  • Completion of any prescribed treatments or medications
  • Additional testing or procedures if ordered during visit

Why Understanding This Code Matters

On Your Medical Bill

This code appears on your medical bills to identify the specific service, procedure, drug, or medical diagnosis you received. Understanding what it means helps you verify you're being charged correctly and know what to expect.

For Your Health

Knowing what this code represents helps you understand your treatment plan, ask better questions during appointments, and track your healthcare journey more effectively.

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