G9916

G9916 — Functional status performed once in the last 12 months

HCPCSActiveBETOS Z2

G9916 is a HCPCS Level II code for functional status performed once in the last 12 months. 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 G9916

Long descriptor: Functional status performed once in the last 12 months
Short descriptor: Funct status past 12 months
Added: January 1, 2018
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to G9916

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9916 is not quite right, the correct code is very often within a few positions of it.

G9908Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
G9909Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months if identified as a tobacco user (e.g., limited life expectancy, other medical reason)terminated
G9910Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period
G9911Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy
G9912Hepatitis b virus (hbv) status assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy
G9913Hepatitis b virus (hbv) status not assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy, reason not otherwise specified
G9914Patient initiated an anti-tnf agent
G9915No record of hbv results documented
G9917Documentation of advanced stage dementia and caregiver knowledge is limited
G9918Functional status not performed, reason not otherwise specified
G9919Screening performed and positive and provision of recommendations
G9920Screening performed and negative
G9921No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specifiedterminated
G9922Safety concerns screen provided and if positive then documented mitigation recommendations
G9923Safety concerns screen provided and negative
G9924Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations, orders or referrals for positive screen (e.g., patient in palliative care, other medical reason)terminated

Questions about G9916

What is HCPCS code G9916?

G9916 is a HCPCS Level II code for functional status performed once in the last 12 months. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G9916?

The CMS HCPCS file marks G9916 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 G9916 paid under the physician fee schedule?

G9916 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.