2025 HCPCS Code G9938

Patients aged 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the six months prior to the measurement period through december 31 of the measurement period

TAGS: plans consecutive months period december through residing during patients older measurement institutional needs prior special

Short Description	Pt 66+ snp or ltc pos > 90d
HCPCS Action Code	N - No maintenance for this code
HCPCS Coverage Code	C - Carrier judgment
HCPCS Code Added Date	January 01, 2018
HCPCS Action Effective Date	January 01, 2024
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