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G9498

G9498Antibiotic regimen prescribed

HCPCSActiveBETOS Z2

G9498 is a HCPCS Level II code for antibiotic regimen prescribed. 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

Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.

The CMS record for G9498

Long descriptor
Antibiotic regimen prescribed

The official wording. This is what the code means.

Short descriptor
Abx reg prescribed

CMS's 28-character form, which is what shows up on a remittance advice.

Added
January 1, 2016

When CMS introduced the code.

BETOS
Z2

Berenson-Eggers Type of Service — CMS's own analytic grouping.

Pricing indicator
00 — Not priced by Part B

Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.

Codes adjacent to G9498

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9498 is not quite right, the correct code is very often within a few positions of it.

  • G9485Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, 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 of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
  • G9486Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, 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
  • G9487Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, 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 of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
  • G9488Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, 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 of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
  • G9489Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, 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 of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
  • G9490Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code
  • G9496Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenomaterminated
  • G9497Received instruction from the anesthesiologist or proxy prior to the day of surgery to abstain from smoking on the day of surgery
  • G9499Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement periodterminated
  • G9500Radiation exposure indices documented in final report for procedure using fluoroscopy
  • G9501Radiation exposure indices not documented in final report for procedure using fluoroscopy, reason not given
  • G9502Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)
  • G9503Patient taking tamsulosin hydrochlorideterminated
  • G9504Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy
  • G9505Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason
  • G9506Biologic immune response modifier prescribedterminated

Questions about G9498

What is HCPCS code G9498?

G9498 is a HCPCS Level II code for antibiotic regimen prescribed. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G9498?

The CMS HCPCS file marks G9498 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 G9498 paid under the physician fee schedule?

G9498 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.

HCPCS Level II2026Q3-Jul· effective July 1, 2026