How To Use HCPCS Code G9982

HCPCS code G9982 describes a remote in-home visit for the evaluation and management of a new patient. This code is specifically used in a Medicare-approved bundled payments for care improvement advanced (BPCI Advanced) model episode of care. It is important to note that this code should only be used when all three key components are met: a comprehensive history, a comprehensive examination, and medical decision making of high complexity. The service is provided in real time using interactive audio and video technology.

1. What is HCPCS G9982?

HCPCS code G9982 is a specific code used to identify a remote in-home visit for the evaluation and management of a new patient. This code is only applicable in a Medicare-approved bundled payments for care improvement advanced (BPCI Advanced) model episode of care. It is important to ensure that all three key components are met: a comprehensive history, a comprehensive examination, and medical decision making of high complexity. The service is provided in real time using interactive audio and video technology. The duration of this visit is typically 60 minutes.

2. Official Description

The official description of HCPCS code G9982 is as follows: “Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved bundled payments for care improvement advanced (BPCI Advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. Counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology.”

3. Procedure

1. The provider initiates a remote in-home visit with a new patient using interactive audio and video technology.
2. The provider conducts a comprehensive history, gathering information about the patient’s medical background, symptoms, and any relevant factors.
3. A comprehensive examination is performed, which may include visual assessments, physical examinations, and other diagnostic procedures as necessary.
4. The provider engages in medical decision making of high complexity, analyzing the patient’s condition, formulating a diagnosis, and developing a treatment plan.
5. Counseling and coordination of care with other physicians, qualified health care professionals, or agencies are provided as needed.
6. The duration of the visit is typically 60 minutes, during which the provider interacts with the patient and/or their family in real time through audio and video intercommunications technology.

4. When to use HCPCS code G9982

HCPCS code G9982 should be used when providing a remote in-home visit for the evaluation and management of a new patient within a Medicare-approved bundled payments for care improvement advanced (BPCI Advanced) model episode of care. It is crucial that all three key components are met: a comprehensive history, a comprehensive examination, and medical decision making of high complexity. The presenting problem(s) should be of moderate to high severity.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9982, healthcare providers should ensure that the following documentation is included:

• A comprehensive history, including relevant medical background and symptoms.
• A comprehensive examination, which may involve visual assessments, physical examinations, and other diagnostic procedures.
• Medical decision making of high complexity, including analysis, diagnosis, and treatment planning.
• Documentation of counseling and coordination of care with other healthcare professionals or agencies, as necessary.

6. Historical Information and Code Maintenance

HCPCS code G9982 was added to the Healthcare Common Procedure Coding System on October 01, 2018. As of now, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code G9982 is payable by Medicare. The pricing indicator code 13 indicates that the price for this service is established by carriers, meaning it is not otherwise classified and is subject to individual determination and carrier discretion. The multiple pricing indicator code A signifies that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of scenarios in which HCPCS code G9982 should be billed:

1. A physician conducts a remote in-home visit with a new patient using interactive audio and video technology. The visit includes a comprehensive history, a comprehensive examination, and medical decision making of high complexity. The duration of the visit is 60 minutes.
2. A nurse practitioner performs a remote in-home visit for the evaluation and management of a new patient. The visit meets the requirements of a comprehensive history, a comprehensive examination, and medical decision making of high complexity. The duration of the visit is 60 minutes.
3. A physician assistant provides a remote in-home visit for a new patient, utilizing interactive audio and video technology. The visit includes a comprehensive history, a comprehensive examination, and medical decision making of high complexity. The duration of the visit is 60 minutes.
4. A specialist conducts a remote in-home visit with a new patient, utilizing audio and video intercommunications technology. The visit meets the criteria of a comprehensive history, a comprehensive examination, and medical decision making of high complexity. The duration of the visit is 60 minutes.
5. A healthcare provider performs a remote in-home visit for the evaluation and management of a new patient. The visit includes a comprehensive history, a comprehensive examination, and medical decision making of high complexity. The duration of the visit is 60 minutes.