2025 HCPCS Code G9490

Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code

TAGS: individual clinical innovation beneficiary performance medication community visit necessarily compliance period staff activities assessment connections billed center functional covered management transitional performed considered patient ensuring limited
Short DescriptionCmmi mod home visit
Product Note0206
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date April 01, 2016
HCPCS Action Effective Date January 01, 2018
HCPCS Pricing Indicator Code 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Type Of Service Code 1 - Medical care
HCPCS Multiple Pricing Indicator Code 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
HCPCS Anesthesia Base Unit Quantity 0
HCPCS Coverage Issues Manual Reference Section Number

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