HCPCS Code G0465 Requires an Invoice

Published 03/07/2025

For dates of service in 2023 and 2024, providers will need to submit an invoice when submitting claims for G0465, Autologous platelet rich plasma (PRP), other blood-derived product for diabetic chronic wounds/ulcers, using an FDA-cleared device for this indication (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment).

HCPCS Code G0465

When billing for autologous PRP:

  • Add a narrative comment to indicate that the autologous prp is being billed
  • An invoice must be submitted for the PRP supply kit that was used
  • Payment will be the total invoice price plus $23.30 for the in-house processing of the autologous PRP


When billing for another blood-derived product:

  • An invoice must be submitted for the blood-derived product
  • Payment will be the total invoice price for the product

Providers are reminded that the total invoice price is the net amount a provider pays after discounts, rebates, refunds and/or additional adjustments. Please review the CMS  Medicare Fraud & Abuse: Prevent, Detect, Report (PDF).

Narrative Comments

Table 1. Electronic Claims.
Electronic Claims
Loop 2300, NTE, 02

Claim Level Comment (Claim Notes):

Used when the documentation does not apply to a specific service line; documentation is applied to entire claim.
Loop 2400, NTE, 02

Line Level Comment (Line Notes):

Used when the documentation applies to a specific service line; documentation is applied to that service line only.
Table 2. Paper Claims.
Paper Claims
Box 19 Enter claim information in this item; if submitting on an attachment, there must be an indication in box “Box 19” to refer to the attached documentation. 
Attachment Attach documentation pertaining to services billed on 1500 claim form.

Documentation Requirements

  • For electronic claims, submit the invoice via eServices or PWK
  • For paper claims, submit the invoice as an attachment to the claim

If an invoice is not submitted, HCPCS code G0465 will be rejected and must be resubmitted as a new claim with the invoice. When covered, each claim for G0465 will be priced individually using the invoice submitted. Providers should follow the appeal process if they disagree with the payment on claims for G0465.

Please see Submitting Additional Documentation for more information on how to submit invoices with your claim.


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