G9367 — At least two orders for high-risk medications from the same drug class
G9367 is a HCPCS Level II code for at least two orders for high-risk medications from the same drug class. 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 G9367
- Long descriptor
- At least two orders for high-risk medications from the same drug class
- Short descriptor
- >= 2 same hi-rsk med ord
- Added
- January 1, 2015
- 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.
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 G9367
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9367 is not quite right, the correct code is very often within a few positions of it.
- 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
- G9365One high-risk medication orderedterminated
- G9366One high-risk medication not orderedterminated
- 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
- G9379Patient did not achieve flat retinas six months post surgeryterminated
- G9380Patient offered assistance with end of life issues or existing end of life plan was reviewed or updated during the measurement period
Questions about G9367
What is HCPCS code G9367?
G9367 is a HCPCS Level II code for at least two orders for high-risk medications from the same drug class. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9367?
The CMS HCPCS file marks G9367 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 G9367 paid under the physician fee schedule?
G9367 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.