G9561 — Patients prescribed opiates for longer than six weeks
G9561 is a HCPCS Level II code for patients prescribed opiates for longer than six weeks. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2021 and is not valid on new claims.
This code has been terminated
CMS terminated G9561 on December 31, 2021. 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 G9561
- Long descriptor
- Patients prescribed opiates for longer than six weeks
- Short descriptor
- Presc opiates >6 wks
- Added
- January 1, 2016
- Terminated
- December 31, 2021
- 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 G9561
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9561 is not quite right, the correct code is very often within a few positions of it.
- G9553Prior thyroid disease diagnosis
- G9554Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging recommended
- G9555Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))
- G9556Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging not recommended
- G9557Final reports for ct, cta, mri or mra studies of the chest or neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule found
- G9558Patient treated with a beta-lactam antibiotic as definitive therapyterminated
- G9559Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)terminated
- G9560Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not giventerminated
- G9562Patients who had a follow-up evaluation conducted at least every three months during opioid therapyterminated
- G9563Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapyterminated
- G9572Index date phq-score greater than 9 documented during the twelve month denominator identification periodterminated
- G9573Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than fiveterminated
- G9574Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five; either phq-9 or phq-9m score was not assessed or is greater than or equal to fiveterminated
- G9577Patients prescribed opiates for longer than six weeksterminated
- G9578Documentation of signed opioid treatment agreement at least once during opioid therapyterminated
- G9579No documentation of signed an opioid treatment agreement at least once during opioid therapyterminated
Questions about G9561
What is HCPCS code G9561?
G9561 is a HCPCS Level II code for patients prescribed opiates for longer than six weeks. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9561?
The CMS HCPCS file marks G9561 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 G9561 still valid?
No. G9561 was terminated on December 31, 2021 and should not be used on new claims.