G4036 HCPCS code: Urgent care mips specialty set
G4036 is the HCPCS Level II code for urgent care mips specialty set. 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 | 2022-01-01 |
| Last action effective | 2022-01-01 |
What changed for G4036
- 2022-01-01: G4036 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 G4036?
G4036 is the HCPCS Level II code for urgent care mips specialty set. Short descriptor: "Urgent care ss".
Does Medicare cover G4036?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G40 codes
- G4000 — Dermatology mips specialty set
- G4001 — Diagnostic radiology mips specialty set
- G4002 — Electrophysiology cardiac specialist mips specialty set
- G4003 — Emergency medicine mips specialty set
- G4004 — Endocrinology mips specialty set
- G4005 — Family medicine mips specialty set
- G4006 — Gastro-enterology mips specialty set
- G4007 — General surgery mips specialty set
- G4008 — Geriatrics mips specialty set
- G4009 — Hospitalists mips specialty set
- G4010 — Infectious disease mips specialty set
- G4011 — Internal medicine mips specialty set
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Next steps
- Run a reimbursement report for a device billed under G4036
- Watch G4036 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G4036
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.