How To Use HCPCS Code G9983

HCPCS code G9983 describes a remote in-home visit for the evaluation and management of an established patient. This code is specifically used in a Medicare-approved bundled payments for care improvement advanced (BPCI Advanced) model episode of care. The visit must meet certain criteria, including the use of interactive audio and video technology, and the provision of counseling and coordination of care with other healthcare professionals or agencies. In this article, we will explore the details of HCPCS code G9983, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS G9983?

HCPCS code G9983 is a specific code used to identify a remote in-home visit for the evaluation and management of an established patient. This visit is conducted using interactive audio and video technology, allowing the healthcare provider to remotely assess the patient’s condition and provide necessary care. The visit must meet certain requirements, including the provision of counseling and coordination of care with other healthcare professionals or agencies. The presenting problem(s) during the visit are typically self-limited or minor, and the visit duration is usually around 10 minutes.

2. Official Description

The official description of HCPCS code G9983 is as follows: “Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved bundled payments for care improvement advanced (BPCI Advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, 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 self-limited or minor. Typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology.”

3. Procedure

1. The healthcare provider initiates a remote in-home visit with an established patient using interactive audio and video technology.
2. During the visit, the provider conducts a problem-focused history, gathering information about the patient’s medical condition and relevant medical history.
3. A problem-focused examination is performed, assessing the patient’s physical condition remotely.
4. The provider engages in straightforward medical decision-making based on the information gathered during the visit.
5. Counseling and coordination of care with other physicians, qualified healthcare professionals, or agencies are provided as needed.
6. The visit typically lasts for approximately 10 minutes and is conducted in real-time via audio and video intercommunications technology.

4. When to use HCPCS code G9983

HCPCS code G9983 should be used when conducting a remote in-home visit for the evaluation and management of an established patient. This code is specifically applicable in a Medicare-approved bundled payments for care improvement advanced (BPCI Advanced) model episode of care. The visit must meet the following criteria:

• At least 2 of the following 3 key components must be present: a problem-focused history, a problem-focused examination, and straightforward medical decision making.
• The visit must be furnished in real-time using interactive audio and video technology.
• Counseling and coordination of care with other physicians, qualified healthcare professionals, or agencies must be provided as necessary.
• The presenting problem(s) during the visit are typically self-limited or minor.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9983, healthcare providers need to ensure that the following documentation requirements are met:

• Documentation should clearly indicate that the visit was conducted remotely using interactive audio and video technology.
• The documentation should include details of the problem-focused history, examination, and medical decision-making performed during the visit.
• Providers should document the counseling and coordination of care provided, including any interactions with other physicians, qualified healthcare professionals, or agencies.
• The documentation should support the nature of the problem(s) and the needs of the patient or family.

6. Historical Information and Code Maintenance

HCPCS code G9983 was added to the Healthcare Common Procedure Coding System on October 01, 2018. As of now, no maintenance actions have been 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 G9983 is payable by Medicare. The pricing indicator code 13 indicates that the price for this code is established by carriers, based on carrier discretion. The multiple pricing indicator code A signifies that the code is not applicable as HCPCS priced under one methodology. Healthcare providers should refer to Medicare guidelines and policies for specific information on reimbursement rates and coverage.

8. Examples

Here are some examples of scenarios where HCPCS code G9983 should be billed:

1. A healthcare provider conducts a remote in-home visit with an established patient using interactive audio and video technology. The visit includes a problem-focused history, examination, and straightforward medical decision-making. The provider also provides counseling and coordination of care with other healthcare professionals. The visit duration is approximately 10 minutes.
2. Another healthcare provider performs a remote in-home visit for an established patient. The visit includes a problem-focused history and examination, along with straightforward medical decision-making. The provider spends 10 minutes with the patient and provides counseling and coordination of care as needed.
3. A third healthcare provider conducts a remote in-home visit for an established patient. The visit involves a problem-focused history, examination, and straightforward medical decision-making. The provider spends 10 minutes with the patient and provides counseling and coordination of care with other physicians or agencies.
4. In a different scenario, a healthcare provider performs a remote in-home visit for an established patient. The visit includes a problem-focused history and examination, along with straightforward medical decision-making. The provider spends 10 minutes with the patient and provides counseling and coordination of care with other qualified healthcare professionals.
5. Lastly, a healthcare provider conducts a remote in-home visit for an established patient. The visit involves a problem-focused history, examination, and straightforward medical decision-making. The provider spends 10 minutes with the patient and provides counseling and coordination of care with other physicians, qualified healthcare professionals, or agencies.