G2116

G2116 — Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period

HCPCSActiveBETOS Z2

G2116 is a HCPCS Level II code for patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.

Medicare coverage: Carrier judgment

Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.

Physician fee schedule statusM

Measurement code. Used for reporting purposes only; never paid.

Global period: XXX

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The CMS record for G2116

Long descriptor: Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period
Short descriptor: Pt 66-80 frailty and adv ill
Added: January 1, 2020
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to G2116

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G2116 is not quite right, the correct code is very often within a few positions of it.

G2107Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period
G2108Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement periodterminated
G2109Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement periodterminated
G2110Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement periodterminated
G2112Patient receiving <=5 mg daily prednisone (or equivalent), or ra activity is worsening, or glucocorticoid use is for less than 6 months
G2113Patient receiving >5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity
G2114Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement periodterminated
G2115Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
G2117Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement periodterminated
G2118Patients 81 years of age and older with at least one claim/encounter for frailty during the measurement period
G2119Within the past 2 years, calcium and/or vitamin d optimization has been ordered or performedterminated
G2120Within the past 2 years, calcium and/or vitamin d optimization has not been ordered or performedterminated
G2121Depression, anxiety, apathy, and psychosis assessed
G2122Depression, anxiety, apathy, and psychosis not assessed
G2123Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement periodterminated
G2124Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and a dispensed dementia medicationterminated

Questions about G2116

What is HCPCS code G2116?

G2116 is a HCPCS Level II code for patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G2116?

The CMS HCPCS file marks G2116 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

How is G2116 paid under the physician fee schedule?

G2116 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.