G0384 Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
Short descriptor: Lev 5 hosp type b ed visit
Look up G0384 alongside ICD-10-CM diagnoses, the HCPCS Table of Drugs, and the AI coding assistant.
G0384 is the HCPCS Level II code for Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) (2026). It belongs to Section G — Procedures / Professional Services (Temporary). Under Medicare, its coverage status is: Carrier judgment. Part B pricing methodology: Not separately priced by Part B.
Classification & CMS Attributes
- Medicare Coverage
- Carrier judgment (code C)
- Part B Pricing
- Not separately priced by Part B (indicator 00)
- Type of Service
- Medical care
- Effective Date
- 2008-01-01
- 2026 Maintenance
- No change this year
References
Cite This Page
Reference G0384 with the canonical source and edition:
G0384 — Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment). ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/G0384
Canonical URL: https://icd10codingpro.com/hcpcs-codes/G0384