G9861 — Patient spent greater than or equal to three days in hospice care
G9861 is a HCPCS Level II code for patient spent greater than or equal to three days in hospice care. 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 G9861
- Long descriptor
- Patient spent greater than or equal to three days in hospice care
- Short descriptor
- Pt more than 3d hospice
- Added
- January 1, 2017
- 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 G9861
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9861 is not quite right, the correct code is very often within a few positions of it.
- G9853Patient admitted to the icu in the last 30 days of lifeterminated
- G9854Patient was not admitted to the icu in the last 30 days of lifeterminated
- G9855Patients who died from cancerterminated
- G9856Patient was not admitted to hospiceterminated
- G9857Patient admitted to hospiceterminated
- G9858Patient enrolled in hospice
- G9859Patients who died from cancer
- G9860Patient spent less than three days in hospice care
- G9862Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)
- G9868Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes
- G9869Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes
- G9870Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes
- G9871Behavioral counseling for diabetes prevention, online, 60 minutes
- G9873First medicare diabetes prevention program (mdpp) core session was attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
- G9874Four total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
- G9875Nine total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
Questions about G9861
What is HCPCS code G9861?
G9861 is a HCPCS Level II code for patient spent greater than or equal to three days in hospice care. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9861?
The CMS HCPCS file marks G9861 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 G9861 paid under the physician fee schedule?
G9861 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.