HCPCS code G9986 — Remote e/m est. pt 40mins. Status: Active. Effective Oct 1, 2018. Source: CMS HCPCS Level II.

G9986

Active

Remote e/m est. pt 40mins

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

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: Oct 1, 2018
Code type: alphanumeric
OPPS Status: B — Code not recognized by OPPS — billed via another route

MUE — Medically Unlikely Edits

Maximum units of G9986 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 2
Practitioner Services 1

Source: CMS Medicare NCCI Medically Unlikely Edits