G9525 — Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)
G9525 is a HCPCS Level II code for documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons). 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 G9525 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 G9525
- Long descriptor
- Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)
- Short descriptor
- Doc pt reas no hospice refer
- Added
- January 1, 2016
- 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 G9525
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9525 is not quite right, the correct code is very often within a few positions of it.
- G9517Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given
- G9518Documentation of active injection drug use
- G9519Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
- G9520Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
- G9521Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months
- G9522Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given
- G9523Patient discontinued from hemodialysis or peritoneal dialysisterminated
- G9524Patient was referred to hospice careterminated
- G9526Patient was not referred to hospice care, reason not giventerminated
- G9529Patient with minor blunt head trauma had an appropriate indication(s) for a head ct
- G9530Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider
- G9531Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar
- G9532Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than traumaterminated
- G9533Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct
- G9534Advanced brain imaging (cta, ct, mra or mri) was not orderedterminated
- G9535Patients with a normal neurological examinationterminated
Questions about G9525
What is HCPCS code G9525?
G9525 is a HCPCS Level II code for documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9525?
The CMS HCPCS file marks G9525 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 G9525 still valid?
No. G9525 was terminated on December 31, 2020 and should not be used on new claims.