# Health Coach Codes

> Educational reference and documentation toolkit for Medicare health and well-being coaching CPT codes 0591T, 0592T and 0593T under the CY 2027 Medicare Physician Fee Schedule Final Rule (CMS-1848-F, released Nov 4, 2026, effective Jan 1, 2027). Written by Angel Reyes, MCHES, MPH, DrPH(c), a health education specialist and former military medic. A Subthesis project.

Key facts, verified against the rule text:

- 0591T (initial assessment), 0592T (follow-up, at least 30 minutes) and 0593T (group of 2+, at least 30 minutes, billed once per beneficiary) remain Category III CPT codes and are nationally priced (status A) from Jan 1, 2027.
- Coaching is an incident-to service furnished by auxiliary personnel under general supervision. Only the supervising physician or practitioner bills Medicare (42 CFR 410.26(b)(5)(iii) and (v)). Coaches, including CHES, MCHES and NBC-HWC, are not independent Medicare billers.
- CMS listed certification pathways that "include, but are not limited to": NBHWC National Standards; NCHEC eligibility for Certified Health Education Specialists; AHNCC standards for Certified Nurse Coaches; and training from Older Americans Act evidence-based programs (ACL). MCHES is not named separately.
- Final work RVUs: 0591T 1.81, 0592T 1.00, 0593T 0.23. Addendum B lists 0592T with global indicator ZZZ (add-on); MAC handling is an open question.
- No frequency limits when reasonable and necessary; the codes remain on the Medicare Telehealth Services List; coaching is not a billable RHC/FQHC visit.
- CMS's Table A-D9 lists no time for 0591T; "60-90 minutes" appears only in the rule's restatement of the proposal.

Content is educational only and is not legal, billing, coding or clinical advice. Not affiliated with CMS, the VA, NCHEC, NBHWC, AHNCC or the AMA. CPT is a registered trademark of the AMA.

## Start here

- [Health Coaching CPT Codes 0591T–0593T: 2027 Medicare Documentation Toolkit](https://healthcoachcodes.com/): Health coaching CPT codes 0591T–0593T under the CY 2027 Medicare Final Rule: who furnishes, who bills, general supervision, and SOAP note templates. By an MCHES®.

## Guides

- [0591T: Health Coaching Initial Assessment (2027 Medicare)](https://healthcoachcodes.com/0591t/): CPT 0591T, the health coaching initial assessment: 2027 Medicare status, who furnishes and who bills, and what to document. By an MCHES®.
- [0592T: Health Coaching Follow-Up CPT Code (2027 Medicare)](https://healthcoachcodes.com/0592t/): CPT 0592T, the health coaching follow-up (30+ min): 2027 Medicare status, the open ZZZ add-on question, same-day pairs and what to document.
- [0593T: Group Health Coaching CPT Code (2027 Medicare)](https://healthcoachcodes.com/0593t/): CPT 0593T, group health coaching (2+ people, 30+ min) billed once per beneficiary: 2027 Medicare status and how to write individualized group notes.
- [Can a CHES® Bill Medicare? CHES and MCHES Coaching in 2027](https://healthcoachcodes.com/ches-mches-health-coaching-medicare/): No, but CMS named NCHEC CHES® eligibility as a pathway to furnish 0591T–0593T under general supervision. What it means and what to keep on file.
- [Can Health Coaches Bill Medicare in 2027? A Guide for Coaches](https://healthcoachcodes.com/for-coaches/): Coaches can't bill Medicare directly, but from 2027 they can furnish 0591T–0593T for practices that bill. How to find, pitch and work with them.
- [Add Health Coaching to a Primary Care Practice (2027 Medicare)](https://healthcoachcodes.com/for-practices/): How a practice adds health coaching under Medicare codes 0591T–0593T in 2027: staffing, supervision, workflow, documentation and billing checks.
- [General Supervision for Health Coaches (2027 Medicare)](https://healthcoachcodes.com/general-supervision-health-coaching/): General supervision for Medicare health coaching in 2027: the practitioner need not be present, but oversight and billing rules apply. 42 CFR 410.26(b)(5).
- [Health Coaching SOAP Note Template for Medicare (0591T–0593T)](https://healthcoachcodes.com/health-coaching-soap-note/): How to write a health coaching SOAP note for Medicare codes 0591T–0593T: each section, must-have fields, an annotated example and mistakes to avoid.
- [Medicare Health Coaching 2027: What the Final Rule Changed](https://healthcoachcodes.com/medicare-health-coaching-2027-final-rule/): What CMS-1848-F changed for health coaching codes 0591T–0593T in 2027: national pricing, general supervision, who may furnish the service, and open questions.
- [Veteran Health Coaching: A Medic's Guide](https://healthcoachcodes.com/veteran-health-coaching/): Coaching veterans in community and Medicare practice: military culture, VA Whole Health, safety protocols and who pays. By a former military medic and MCHES®.

## Help center

- [Can 0592T be billed without 0591T?](https://healthcoachcodes.com/help/0592t-add-on-zzz/): Unresolved. Addendum B lists 0592T with the "ZZZ" global indicator used for add-on codes, mirroring its crosswalk 99489.
- [Can multiple units of 0593T be billed for a long group session?](https://healthcoachcodes.com/help/0593t-multiple-units/): The final rule doesn't explicitly rule on it. Commenters asked for multiple units for longer sessions (p.
- [Is there an affiliate program?](https://healthcoachcodes.com/help/affiliate-program/): An affiliate program is planned through Teachable. Approved affiliates will earn a commission and must disclose the relationship and describe the toolkit…
- [Is audio-only (phone) coaching allowed?](https://healthcoachcodes.com/help/audio-only-coaching/): The rule notes that audio-only telehealth flexibilities for patients at home are extended through the end of 2027 under the Consolidated Appropriations…
- [Can a coach work as an independent contractor for a practice?](https://healthcoachcodes.com/help/can-coaches-work-as-contractors/): The final rule doesn't address contracting arrangements. Contractor, employment and CBO arrangements all raise supervision, reassignment and compliance…
- [Can health coaches bill Medicare directly?](https://healthcoachcodes.com/help/can-health-coaches-bill-medicare/): No. Under the CY 2027 final rule, coaching is furnished by qualified auxiliary personnel incident to a practitioner's services, and only the supervising…
- [Can I share the toolkit with my team?](https://healthcoachcodes.com/help/can-i-share-the-toolkit/): A single purchase is a personal license for your own work or within the organization you work for; it doesn't allow redistribution or shared access.
- [Can a solo, private-practice coach bill Medicare for coaching?](https://healthcoachcodes.com/help/can-solo-coaches-bill-medicare/): Not on their own. A coach needs a relationship with an eligible practitioner who supervises and bills, such as employment, a contract, or affiliation…
- [Can the supervisor differ from the treating practitioner?](https://healthcoachcodes.com/help/can-supervisor-differ-from-treating/): Yes. 42 CFR 410.26(b)(5)(iv) says the practitioner supervising the auxiliary personnel need not be the same practitioner treating the patient more broadly.
- [Can coaches employed by community-based organizations furnish the service?](https://healthcoachcodes.com/help/cbo-coaches/): Yes. Auxiliary personnel employed by, or affiliated with, a community-based organization that employs health coaches may furnish coaching under general…
- [How is health coaching different from chronic care management (CCM)?](https://healthcoachcodes.com/help/ccm-vs-health-coaching/): CCM is monthly, time-based care management for patients with two or more chronic conditions and a comprehensive care plan.
- [Can I use the same note text for every session?](https://healthcoachcodes.com/help/cloned-notes/): No. Copied-forward or cloned notes are a known audit concern. Templates should prompt you for fields, never supply the content; record what actually…
- [Does CMS list documentation requirements for health coaching?](https://healthcoachcodes.com/help/cms-documentation-requirements/): Not specifically. The final rule's coaching section (pp. 374–387) lists no coaching-specific documentation, referral, plan-of-care or consent requirements.
- [How do CHI codes G0019 and G0022 differ from coaching?](https://healthcoachcodes.com/help/community-health-integration-g0019/): G0019 and G0022 are Medicare community health integration (CHI) codes for certified or trained auxiliary personnel, such as community health workers…
- [Does the toolkit offer continuing education credit?](https://healthcoachcodes.com/help/continuing-education/): Not at this time. The toolkit is an educational resource and does not currently carry NCHEC or NBHWC continuing education credit.
- [What should be in a coach's credential file?](https://healthcoachcodes.com/help/credential-file-checklist/): Proof of the certification pathway (and its status), evidence of coaching-specific training, OIG exclusion screening at hire and periodically, and proof…
- [Did CMS replace 0591T–0593T with G-codes?](https://healthcoachcodes.com/help/did-cms-create-g-codes/): No. CMS considered HCPCS G-codes and declined. It kept the Category III CPT codes and their prefatory language because they are recognized nationally…
- [Do health coaches need to enroll in Medicare or get an NPI?](https://healthcoachcodes.com/help/do-coaches-enroll-in-medicare/): The coaching codes are billed by the supervising practitioner, so coaches do not enroll to bill them.
- [Do nurse coaches qualify, and can they bill directly?](https://healthcoachcodes.com/help/do-nurse-coaches-qualify/): CMS named AHNCC national standards for Certified Nurse Coaches as a pathway.
- [Does a CHES® qualify to provide Medicare health coaching?](https://healthcoachcodes.com/help/does-ches-qualify/): CMS named "National Commission for Health Education Credentialing eligibility for Certified Health Education Specialists" as one pathway in a…
- [Does NBC-HWC board certification qualify?](https://healthcoachcodes.com/help/does-nbc-hwc-qualify/): CMS named "fulfilling the National Board for Health and Wellness Coaching National Standards" as a pathway.
- [Does the supervising practitioner need to be on site?](https://healthcoachcodes.com/help/does-practitioner-need-to-be-onsite/): No. Under general supervision, the practitioner does not need to be physically present during the coaching session.
- [Does the coach receive the Medicare payment?](https://healthcoachcodes.com/help/does-the-coach-get-paid-by-medicare/): No. Medicare pays the billing practitioner. How a coach is compensated is set by their employment or contract with the practice or organization, not by…
- [Will using the toolkit guarantee my claims are paid?](https://healthcoachcodes.com/help/does-the-toolkit-guarantee-payment/): No. Templates help you document clearly, but payment depends on coverage, medical necessity, the actual service, correct billing and MAC processing.
- [Does the VA Community Care Network pay for health coaching?](https://healthcoachcodes.com/help/does-va-pay-for-coaching/): We found no source showing coaching is a covered VA Community Care Network service.
- [Can coaching time also count toward CCM or other time-based services?](https://healthcoachcodes.com/help/double-counting-time/): Don't count the same minutes twice. Time documented for a coaching session shouldn't also be counted toward a CCM monthly threshold or another time-based…
- [Does the CHES pathway require active certification or just eligibility?](https://healthcoachcodes.com/help/eligibility-vs-active-certification/): The rule doesn't say. It names NCHEC "eligibility for Certified Health Education Specialists" without stating whether active certification or eligibility…
- [What are the final RVUs for 0591T–0593T?](https://healthcoachcodes.com/help/final-rvus/): Final work RVUs are 1.81 (0591T), 1.00 (0592T) and 0.23 (0593T). Total RVUs are 4.22 / 2.30 (0591T, non-facility / facility), 2.27 / 1.29 (0592T) and…
- [Is there a limit on how many coaching sessions Medicare covers?](https://healthcoachcodes.com/help/frequency-limits/): CMS did not finalize frequency limits, "as long as they are reasonable and necessary" (rule pp. 384–385).
- [How do I document a group (0593T) session?](https://healthcoachcodes.com/help/group-documentation/): Keep a group record (topic, modality, start and stop times, roster) plus an individualized entry for each billed beneficiary describing their…
- [Can group coaching (0593T) be done over video?](https://healthcoachcodes.com/help/group-telehealth/): 0593T is on the telehealth list like the other coaching codes. The same documentation rules apply: a group record plus an individualized entry for each…
- [What should a Medicare health coach job description include?](https://healthcoachcodes.com/help/health-coach-job-description/): The qualifying certification pathway and coaching-specific training, the supervising practitioner relationship, duties (initial, follow-up and group…
- [How do I access the toolkit after buying?](https://healthcoachcodes.com/help/how-do-i-access-the-toolkit/): The toolkit is delivered through Teachable. After checkout you will get access to the course and downloads from your Teachable account using the email…
- [How much does Medicare pay for health coaching?](https://healthcoachcodes.com/help/how-much-does-medicare-pay/): Estimated national non-facility amounts are about $137.69 for 0591T, $74.07 for 0592T and $22.51 per beneficiary for 0593T. These are calculated from…
- [How should coaching time be documented?](https://healthcoachcodes.com/help/how-to-document-time/): Record actual start and stop times for every session. 0592T and 0593T require at least 30 minutes; CMS's final table lists no time for 0591T, so follow…
- [Help Center: Medicare Health Coaching Codes 0591T–0593T](https://healthcoachcodes.com/help/): Short, cited answers on Medicare health coaching codes 0591T–0593T: who furnishes and bills, supervision, documentation, telehealth, payment and the toolkit.
- [Does coaching need a practitioner order or plan of care?](https://healthcoachcodes.com/help/is-an-order-required/): The final rule doesn't spell one out for coaching, but because coaching is an incident-to service, documenting the practitioner's order or plan of care…
- [Can health coaching be delivered by telehealth?](https://healthcoachcodes.com/help/is-coaching-on-telehealth-list/): The codes have been on the Medicare Telehealth Services List since CY 2024, and CMS kept them on the CY 2027 list ("Maintain").
- [Is MCHES® named in the final rule?](https://healthcoachcodes.com/help/is-mches-named/): Not in CMS's finalized language. MCHES® appears only in the summary of public comments (p. 381).
- [Does national pricing guarantee payment?](https://healthcoachcodes.com/help/is-payment-guaranteed/): No. Status A means the codes are payable under the fee schedule. Each claim still depends on coverage, medical necessity, documentation, correct billing…
- [Is the toolkit CMS-approved or endorsed?](https://healthcoachcodes.com/help/is-the-toolkit-cms-approved/): No. CMS does not approve templates or credentials, and Health Coach Codes is not affiliated with or endorsed by CMS, the VA, NCHEC, NBHWC, AHNCC or the…
- [Does the rule apply to Medicare Advantage or Medicaid?](https://healthcoachcodes.com/help/is-this-only-original-medicare/): The rule sets payment under the Original Medicare Physician Fee Schedule.
- [How do the coaching codes differ from the MDPP?](https://healthcoachcodes.com/help/mdpp-vs-health-coaching/): MDPP suppliers enroll in Medicare and bill directly for a CDC-recognized prediabetes curriculum.
- [Can dietitians or CHWs furnish health coaching?](https://healthcoachcodes.com/help/other-professions/): Commenters asked CMS to name RDs, CHWs, pharmacists, social workers and others.
- [Do patients need to consent to health coaching?](https://healthcoachcodes.com/help/patient-consent/): The final rule doesn't address consent for coaching. Many organizations use a coaching consent form that explains the service and possible cost sharing…
- [Do patients pay a copay or coinsurance for coaching?](https://healthcoachcodes.com/help/patient-cost-sharing/): The final rule doesn't address cost sharing for these codes, and nothing designates them as preventive services exempt from it.
- [What is the refund policy?](https://healthcoachcodes.com/help/refund-policy/): Refund terms are shown on the Teachable checkout page at the time of purchase, and Teachable's terms apply to the transaction. Questions?
- [Can rural health clinics or FQHCs bill coaching as a visit?](https://healthcoachcodes.com/help/rhc-fqhc/): No. CMS states that coaching furnished under the general supervision of an RHC or FQHC practitioner does not constitute a billable RHC or FQHC visit…
- [Which codes can't be billed on the same day as coaching?](https://healthcoachcodes.com/help/same-day-exclusions/): CPT parenthetical guidance indicates 0592T shouldn't be reported with 96156, 96158, 96159, 98960, 0488T or 0591T, and 0593T shouldn't be reported with…
- [What should a coach do if a patient raises a clinical issue?](https://healthcoachcodes.com/help/scope-and-referrals/): Document it and route it to the supervising practitioner according to policy.
- [How much does the toolkit cost?](https://healthcoachcodes.com/help/toolkit-price/): The Health Coach Codes toolkit will be $197, a one-time purchase with no subscription. It is coming soon, and checkout will be handled by Teachable.
- [Will the toolkit be updated when rules change?](https://healthcoachcodes.com/help/toolkit-updates/): Content is dated with a "Last verified" stamp and reviewed when the Federal Register version publishes and when MAC, CMS or NCHEC guidance appears.
- [Can veterans use the GI Bill for coaching certification?](https://healthcoachcodes.com/help/veteran-coach-gi-bill/): NBHWC reports that its board-certification exam fee can be reimbursed under the Post-9/11 GI Bill (VA Form 22-0803); the application fee is not covered.
- [What should a coach do if a veteran is in crisis?](https://healthcoachcodes.com/help/veteran-crisis/): net, and follow your organization's emergency protocol and notify the supervising practitioner.
- [What are CPT codes 0591T, 0592T and 0593T?](https://healthcoachcodes.com/help/what-are-0591t-0592t-0593t/): They are the three Category III CPT codes for health and well-being coaching: 0591T for an individual initial assessment, 0592T for an individual…
- [What changed between the proposed and final rule?](https://healthcoachcodes.com/help/what-changed-proposed-vs-final/): CMS switched from direct to general supervision, raised the work RVUs for 0591T (1.00 to 1.81) and 0592T (0.70 to 1.00), kept 0593T at 0.23, and kept the…
- [What should a health coaching note include?](https://healthcoachcodes.com/help/what-goes-in-a-coaching-note/): Date, actual start and stop times, modality, the link to the practitioner's plan of care, the patient's goals and progress, next steps, any referral back…
- [What is a supervision log, and is it required?](https://healthcoachcodes.com/help/what-is-a-supervision-log/): A supervision log records who supervised, how the practitioner was available, and when charts were reviewed.
- [What is general supervision for health coaching?](https://healthcoachcodes.com/help/what-is-general-supervision/): The service is furnished under the practitioner's overall direction and control, but the practitioner does not need to be physically present.
- [How does CPT define health and well-being coaching?](https://healthcoachcodes.com/help/what-is-health-and-well-being-coaching/): CMS adopted the CPT prefatory language: a patient-centered approach in which patients set their own goals, use self-discovery or active learning with…
- [What does "incident to" mean for coaching?](https://healthcoachcodes.com/help/what-is-incident-to/): An incident-to service is furnished by auxiliary personnel as part of a physician's or other practitioner's services and billed by that practitioner.
- [What's in the Health Coach Codes toolkit?](https://healthcoachcodes.com/help/whats-in-the-toolkit/): SOAP-style note templates for 0591T, 0592T and 0593T (DOCX and fillable PDF), a practitioner order and plan-of-care template, a supervision log, a…
- [When does Medicare start paying nationally for health coaching?](https://healthcoachcodes.com/help/when-does-medicare-start-paying/): January 1, 2027. CMS released the CY 2027 Physician Fee Schedule Final Rule (CMS-1848-F) on November 4, 2026, giving 0591T–0593T national payment (status…
- [Where can I read the final rule myself?](https://healthcoachcodes.com/help/where-to-read-the-rule/): Start with CMS's CMS-1848-F page and the Federal Register public-inspection copy (document 2026-22743).
- [Which credentials qualify someone to furnish health coaching?](https://healthcoachcodes.com/help/which-credentials-qualify/): CMS requires appropriate certification and lists pathways that "include, but are not limited to" NBHWC National Standards, NCHEC eligibility for…
- [Who submits the claim for 0591T–0593T?](https://healthcoachcodes.com/help/who-bills-health-coaching/): The supervising physician or other eligible practitioner. The regulation says only the supervising practitioner may bill Medicare for incident-to…
- [Who is the toolkit for?](https://healthcoachcodes.com/help/who-is-the-toolkit-for/): CHES®/MCHES® health educators, NBC-HWC and nurse coaches, practice and clinic managers, and community-based organizations working with Medicare patients…
- [Who wrote the toolkit?](https://healthcoachcodes.com/help/who-wrote-the-toolkit/): Angel Reyes, MCHES®, MPH, DrPH(c), a Master Certified Health Education Specialist and former military medic with nearly 10 years of service.
- [How does VA Whole Health relate to Medicare health coaching?](https://healthcoachcodes.com/help/whole-health-and-coaching/): VA Whole Health is a framework built around "what matters to you," with the Circle of Health at its center.

## Blog

- [Chronic Care Management vs Health Coaching (0591T)](https://healthcoachcodes.com/blog/chronic-care-management-vs-health-coaching/): CCM and health coaching both use clinical staff under general supervision, and the 2027 coaching values are even crosswalked to complex CCM.
- [Health Coaching in Medicare: A Timeline from 2020 to 2027](https://healthcoachcodes.com/blog/health-coaching-road-to-medicare-timeline/): A dated timeline of how health and well-being coaching codes 0591T–0593T went from emerging-service codes to nationally priced Medicare services, and…
- [Health Coaching Services Agreements: 9 Questions](https://healthcoachcodes.com/blog/health-coaching-services-agreement-questions/): Coaches and practices are drafting contracts for 2027 Medicare coaching. These are the topics to raise with healthcare counsel before anyone signs.
- [An MCHES® on the 2027 Medicare Health Coaching Rule](https://healthcoachcodes.com/blog/health-education-specialists-medicare-coaching-2027/): The final Medicare coaching rule names the CHES® credential pathway. A Master Certified Health Education Specialist on what that opens up, what it…
- [Blog: Medicare Health Coaching Notes](https://healthcoachcodes.com/blog/): Field notes on Medicare health coaching codes 0591T–0593T: rule updates, documentation lessons and practical advice, by an MCHES® and former medic.
- [Medicare DPP vs Health Coaching Codes](https://healthcoachcodes.com/blog/medicare-diabetes-prevention-program-vs-health-coaching/): MDPP and the 0591T–0593T coaching codes both use coaches to drive behavior change, but they work in opposite ways: MDPP suppliers enroll and bill…
- [A Military Medic's Lessons for Health Coaching Notes](https://healthcoachcodes.com/blog/military-medic-lessons-health-coaching/): Field lessons from nearly ten years as a military medic that translate directly to documenting and delivering Medicare health coaching.

## About & sources

- [About Angel Reyes, MCHES®, MPH, DrPH(c)](https://healthcoachcodes.com/about/): Angel Reyes, MCHES®, MPH, DrPH(c), health education specialist and former military medic, and how Health Coach Codes is researched and kept current.
- [Contact](https://healthcoachcodes.com/contact/): Contact Health Coach Codes by email or LinkedIn with questions about the 0591T–0593T documentation toolkit, corrections, or partnerships.
- [Sources & Updates: CMS-1848-F Citations](https://healthcoachcodes.com/sources/): Primary sources behind Health Coach Codes (CMS-1848-F, Addendum B, 42 CFR 410.26(b)(5), the telehealth list, NCHEC), plus a dated change log and open questions.

## Optional

- [Affiliate Disclosure](https://healthcoachcodes.com/affiliate-disclosure/): How Health Coach Codes' affiliate program works and how affiliate relationships are disclosed, consistent with FTC guidance.
- [Disclaimer: Educational Use Only](https://healthcoachcodes.com/disclaimer/): Health Coach Codes is educational only and is not legal, billing, coding, or clinical advice. Your supervising practitioner's and organization's policies come first.
- [Privacy Policy](https://healthcoachcodes.com/privacy/): How Health Coach Codes handles information: no tracking cookies or analytics on this site, email you choose to send, and purchases processed by Teachable.
- [Terms of Use](https://healthcoachcodes.com/terms/): Terms of use for the Health Coach Codes website and toolkit: educational use, license, purchases through Teachable, and limitations.

Full text of every page: https://healthcoachcodes.com/llms-full.txt