HCPCS code G0009 — Admin pneumococcal vaccine.
Status: Active.
Effective Jan 1, 1996.
Source: CMS HCPCS Level II.
G0009
ActiveAdmin pneumococcal vaccine
Administration of pneumococcal vaccine
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 1996
Code type:
alphanumeric
OPPS Status:
S
— Significant procedure — not subject to multiple procedure reduction
OPPS APC:
5691
Medicare Part B utilization — 2023
Services billed
18,400,000
Beneficiaries
9,200,000
Medicare paid
$368,000,000
Avg per service
$25.00
Source: Medicare Part B Provider Utilization Public Use File (anonymized, aggregated to HCPCS level).
MUE — Medically Unlikely Edits
Maximum units of G0009 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 1 |
| Practitioner Services | 1 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits — Reverse Direction
G0009 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0162 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)