G2094 HCPCS code: Documentation of patient reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., patient declined, other patient reasons)
G2094 is the HCPCS Level II code for documentation of patient reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., patient declined, other patient reasons). Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2020-01-01 |
| Last action effective | 2020-01-01 |
What changed for G2094
- 2020-01-01: G2094 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G2094?
G2094 is the HCPCS Level II code for documentation of patient reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., patient declined, other patient reasons). Short descriptor: "Pt rsn no ace arn arni".
Does Medicare cover G2094?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G20 codes
- G2000 — Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), performed in an approved ide-based clinical trial, per treatment session
- G2001 — Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2002 — Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2003 — Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2004 — Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2005 — Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2006 — Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2007 — Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2008 — Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2009 — Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)
- G2010 — Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment
- G2011 — Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes
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Next steps
- Run a reimbursement report for a device billed under G2094
- Watch G2094 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G2094
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.