Physical Activity and Nutrition Risk Assessment

What is the Physical Activity and Nutrition Risk Assessment?

The Centers for Medicare & Medicaid Services (CMS) began reimbursing for Social Determinants of Health (SDOH) Risk Assessment on January 1, 2024 and revised the definition as of January 1, 2026 to Physical Activity and Nutrition Risk Assessment. The Physical Activity and Nutrition Risk Assessment helps a practitioner understand the physical activity and nutrition needs of a Traditional Medicare patient that may affect the patient's diagnosis or treatment. The Physical Activity and Nutrition Risk Assessment must be provided using a standardized, evidence-based tool.

Medicare Part B covers one Physical Activity and Nutrition Risk Assessment every six months. The Physical Activity and Nutrition Risk Assessment is not intended to be a routine screening, but rather an assessment administered when the the patient has one or more known or suspected physical activity and/or nutrition need that may affect their diagnosis and treatment. A practitioner may perform a physical activity and nutrition risk assessment or either a physical activity or nutrition risk assessment when reasonable and necessary. The Physical Activity and Nutrition Risk Assessment may be provided by telehealth.

The Physical Activity and Nutrition Risk Assessment is an optional addition to the Annual Wellness Visit (AWV). There is an add-on payment for the Physical Activity and Nutrition Risk Assessment, but there is no cost sharing when conducted during an AWV.

The Physical Activity and Nutrition Risk Assessment can be provided during an Evaluation and Management (E/M) visit, with the exception of level 1 visits performed by clinical staff. The Physical Activity and Nutrition Risk Assessment can also be provided during a behavioral health visit, psychiatric diagnostic evaluation, or Health Behavior Assessment and Intervention (HBAI) service. The Physical Activity and Nutrition Risk Assessment does not have to be performed at the same time as an E/M or behavioral health visit but will most often be provided at the same time. There is an add-on payment for a Physical Activity and Nutrition Risk Assessment conducted during an office or behavioral health visit and the usual Medicare Part B cost sharing requirement applies. CMS recommends practitioners notify the patient about cost sharing prior to administering the assessment.

Why conduct a Physical Activity and Nutrition Risk Assessment?

Providers can use results of the Physical Activity and Nutrition Risk Assessment to identify a patient's physical activity and nutrition needs, inform medical decision-making, and refer patients to relevant resources. Providers may also review results of the Physical Activity and Nutrition Risk Assessments for all of their patients in aggregate to understand community-level needs and inform proactive approaches to addressing these needs.

Who can provide a Physical Activity and Nutrition Risk Assessment?

The Physical Activity and Nutrition Risk Assessment can be provided by a:

• Physician
• Physician assistant
• Nurse practitioner
• Clinical nurse specialist
• Certified nurse midwife
• Medical professional working under the direct supervision of a billing practitioner "incident to" their professional services

What tools can be used to conduct a Physical Activity and Nutrition Risk Assessment?

Practitioners need to use a standardized, evidence-based tool to assess physical activity and nutrition.

Example nutrition assessment tools include:

• Mini-EAT tool
• Starting the Conversation Diet tool
• Short Dietary Assessment Instruments

Example physical activity assessment tools include:

• Physical Activity Vital Sign tool
• CHAMPS Physical Activity Questionnaire for Older Adults
• Rapid Assessment of Physical Activity (RAPA) or Telephone Assessment of Physical Activity (TAPA)

What is the billing code for the Physical Activity and Nutrition Risk Assessment?

There is one HCPCS code for the Physical Activity and Nutrition Risk Assessment:

• G0136: Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months.

When the Physical Activity and Nutrition Risk Assessment is provided as an additional element of the AWV, include G0136 with modifier –33 on the same claim as the AWV (HCPCS codes G0438 or G0439) for the same date of service as the AWV.

G0136 is on the Medicare telehealth list.

Are there any special considerations for Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) billing for Physical Activity and Nutrition Risk Assessment?

RHCs and FQHCs can bill for the Physical Activity and Nutrition Risk Assessment as part of an RHC or FQHC visit, or AWV. The Physical Activity and Nutrition Risk Assessment is considered part of the RHC or FQHC visit and is not a separately reimbursable code. There is no patient cost sharing for an Physical Activity and Nutrition Risk Assessment that is conducted during an AWV. Patient cost sharing does apply when the Physical Activity and Nutrition Risk Assessment is provided with other visits.

Resources

• Care Management, Centers for Medicare & Medicaid Services
• CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program, Federal Register

Last Updated: 02/20/2026
Last Reviewed: 02/20/2026