G9187 — Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code
G9187 is a HCPCS Level II code for bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code. 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 statusA
Active code. Paid separately under the physician fee schedule.
- Work RVU
- 0.18
- PE (non-facility)
- 1.32
- PE (facility)
- 1.32
- Malpractice RVU
- 0.03
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of G9187 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 3 — Date of Service Edit: Clinical · Nature of Service/Procedure
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for G9187
- Long descriptor
- Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code
- Short descriptor
- Bpci home visit
- Added
- October 1, 2013
- BETOS
- M5D
- Pricing indicator
- 13 — Physician fee schedule
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Price established by carriers — not otherwise classified, individual determination, or carrier discretion.
Codes adjacent to G9187
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9187 is not quite right, the correct code is very often within a few positions of it.
- G9170Memory functional limitation, discharge status at discharge from therapy or to end reportingterminated
- G9171Voice functional limitation, current status at therapy episode outset and at reporting intervalsterminated
- G9172Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingterminated
- G9173Voice functional limitation, discharge status at discharge from therapy or to end reportingterminated
- G9174Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervalsterminated
- G9175Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingterminated
- G9176Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reportingterminated
- G9186Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reportingterminated
- G9188Beta-blocker therapy not prescribed, reason not given
- G9189Beta-blocker therapy prescribed or currently being taken
- G9190Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)
- G9191Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)
- G9192Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)terminated
- G9193Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depressionterminated
- G9194Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phaseterminated
- G9195Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phaseterminated
Questions about G9187
What is HCPCS code G9187?
G9187 is a HCPCS Level II code for bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9187?
The CMS HCPCS file marks G9187 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 G9187 paid under the physician fee schedule?
G9187 carries PFS status code A. Active code. Paid separately under the physician fee schedule.