G9680 — This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary
G9680 is a HCPCS Level II code for this code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary. 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 statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
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 G9680
- Long descriptor
- This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary
- Short descriptor
- Acute care congestive heart
- Added
- October 1, 2016
- 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 G9680
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9680 is not quite right, the correct code is very often within a few positions of it.
- G9672All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patientterminated
- G9673I intend to report the cardiovascular prevention measures groupterminated
- G9674Patients with clinical ascvd diagnosis
- G9675Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl
- G9676Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70-189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period
- G9677All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patientterminated
- G9678Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreementterminated
- G9679This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiary
- G9681This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiary
- G9682This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiary
- G9683Facility service(s) for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder. (may only be billed once per day per beneficiary). this service is for a demonstration project
- G9684This code is for the onsite acute care treatment of a nursing facility resident for a uti; may only be billed once per day per beneficiary
- G9685Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a demonstration project
- G9686Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing facility interdisciplinary care teamterminated
- G9687Hospice services provided to patient any time during the measurement period
- G9688Patients using hospice services any time during the measurement period
Questions about G9680
What is HCPCS code G9680?
G9680 is a HCPCS Level II code for this code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9680?
The CMS HCPCS file marks G9680 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 G9680 paid under the physician fee schedule?
G9680 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.