G9480 HCPCS code: Admission to medicare care choice model program (mccm)

G9480 is the HCPCS Level II code for admission to medicare care choice model program (mccm). Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on outpatient hospital claims.

Code details

NCCI unit limits (MUE)

What changed for G9480

• 2016-01-01: G9480 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 G9480?

G9480 is the HCPCS Level II code for admission to medicare care choice model program (mccm). Short descriptor: "Admission to mccm".

Does Medicare cover G9480?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

How many units of G9480 can be billed per day?

1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).

Related G94 codes

• G9400 — Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons
• G9401 — No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment
• G9402 — Patient received follow-up within 30 days after discharge
• G9403 — Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)
• G9404 — Patient did not receive follow-up within 30 days after discharge
• G9405 — Patient received follow-up within 7 days after discharge
• G9406 — Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)
• G9407 — Patient did not receive follow-up within 7 days after discharge
• G9408 — Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days
• G9409 — Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days
• G9410 — Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
• G9411 — Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision

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Next steps

• Run a reimbursement report for a device billed under G9480
• Watch G9480 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for G9480

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.

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