G9365 — One high-risk medication ordered
G9365 is a HCPCS Level II code for one high-risk medication ordered. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2020 and is not valid on new claims.
This code has been terminated
CMS terminated G9365 on December 31, 2020. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
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.
The CMS record for G9365
- Long descriptor
- One high-risk medication ordered
- Short descriptor
- 1high risk med ord
- Added
- January 1, 2015
- Terminated
- December 31, 2020
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
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.
When CMS retired it.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G9365
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9365 is not quite right, the correct code is very often within a few positions of it.
- G9357Post-partum screenings, evaluations and education performed
- G9358Post-partum screenings, evaluations and education not performed
- G9359Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to treatment with a biologic immune response modifierterminated
- G9360No documentation of negative or managed positive tb screenterminated
- G9361Medical indication for delivery by cesarean birth or induction of labor (<39 weeks of gestation) [documentation of reason(s) for elective delivery (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes (premature or prolonged), maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]
- G9362Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia recordterminated
- G9363Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia recordterminated
- G9364Sinusitis caused by, or presumed to be caused by, bacterial infection
- G9366One high-risk medication not orderedterminated
- G9367At least two orders for high-risk medications from the same drug class
- G9368At least two orders for high-risk medications from the same drug class not ordered
- G9369Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greaterterminated
- G9370Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greaterterminated
- G9376Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgeryterminated
- G9377Patient did not have the retina attached after 6 months following only one surgeryterminated
- G9378Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)terminated
Questions about G9365
What is HCPCS code G9365?
G9365 is a HCPCS Level II code for one high-risk medication ordered. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9365?
The CMS HCPCS file marks G9365 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.
Is G9365 still valid?
No. G9365 was terminated on December 31, 2020 and should not be used on new claims.