G9891 HCPCS code: Mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the payable mdpp expanded model hcpcs code (this code is for reporting purposes only)
G9891 is the HCPCS Level II code for mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the payable mdpp expanded model hcpcs code (this code is for reporting purposes only). 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 | Y1 |
| Added | 2018-04-01 |
| Last action effective | 2018-04-01 |
What changed for G9891
- 2018-04-01: G9891 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 G9891?
G9891 is the HCPCS Level II code for mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the payable mdpp expanded model hcpcs code (this code is for reporting purposes only). Short descriptor: "Em session reporting".
Does Medicare cover G9891?
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
- G9804 — Patient was not 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
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Next steps
- Run a reimbursement report for a device billed under G9891
- Watch G9891 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9891
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.