G9960 — Documentation of medical reason(s) for prescribing systemic antimicrobials
G9960 is a HCPCS Level II code for documentation of medical reason(s) for prescribing systemic antimicrobials. 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 G9960
- Long descriptor
- Documentation of medical reason(s) for prescribing systemic antimicrobials
- Short descriptor
- Med rsn sys antimi nt rx
- Added
- January 1, 2018
- 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 G9960
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9960 is not quite right, the correct code is very often within a few positions of it.
- G9948Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomyterminated
- G9949Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively
- G9954Patient exhibits 2 or more risk factors for post-operative vomiting
- G9955Cases in which an inhalational anesthetic is used only for induction
- G9956Patient received combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
- G9957Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)
- G9958Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
- G9959Systemic antimicrobials not prescribed
- G9961Systemic antimicrobials prescribed
- G9962Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery anatomy
- G9963Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine artery anatomy
- G9964Patient received at least one well-child visit with a pcp during the performance period
- G9965Patient did not receive at least one well-child visit with a pcp during the performance period
- G9966Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and reportterminated
- G9967Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and reportterminated
- G9968Patient was referred to another clinician or specialist during the measurement period
Questions about G9960
What is HCPCS code G9960?
G9960 is a HCPCS Level II code for documentation of medical reason(s) for prescribing systemic antimicrobials. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9960?
The CMS HCPCS file marks G9960 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 G9960 paid under the physician fee schedule?
G9960 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.