G9804 HCPCS code: Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
G9804 is the HCPCS Level II code for patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami. CMS terminated G9804 on 2020-12-31; do not bill it for later dates of service. 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 | 2017-01-01 |
| Last action effective | 2021-01-01 |
| Terminated | 2020-12-31 |
What changed for G9804
- 2017-01-01: G9804 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 G9804?
G9804 is the HCPCS Level II code for patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami. Short descriptor: "Pt not presc 135 day trmt".
Does Medicare cover G9804?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G98 codes
- G9800 — Patients who are identified as having an intolerance or allergy to beta-blocker therapy
- G9801 — Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis
- G9802 — Patients who use hospice services any time during the measurement period
- G9803 — Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
- G9805 — Patients who use hospice services any time during the measurement period
- G9806 — Patients who received cervical cytology or an hpv test
- G9807 — Patients who did not receive cervical cytology or an hpv test
- G9808 — Any patients who had no asthma controller medications dispensed during the measurement year
- G9809 — Patients who use hospice services any time during the measurement period
- G9810 — Patient achieved a pdc of at least 75% for their asthma controller medication
- G9811 — Patient did not achieve a pdc of at least 75% for their asthma controller medication
- G9812 — Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure
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Next steps
- Run a reimbursement report for a device billed under G9804
- Watch G9804 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9804
Sources: CMS HCPCS Level II release October 2025; 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.