2025 HCPCS Code G9986

Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology

TAGS: consistent remote agencies patient management technology advanced provided needs video nature moderate intercommunications minutes comprehensive qualified making health professionals spent furnished requires interactive decision coordination audio presenting model visit bundled medical improvement using counseling family evaluation episode payments least established
Short DescriptionRemote e/m est. pt 40mins
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date October 01, 2018
HCPCS Action Effective Date October 01, 2018
HCPCS Pricing Indicator Code 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
HCPCS Type Of Service Code 1 - Medical care
HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
HCPCS Anesthesia Base Unit Quantity 0
HCPCS Coverage Issues Manual Reference Section Number

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