G9986 Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
Short descriptor: Remote e/m est. pt 40mins
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G9986 is the HCPCS Level II code for Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology (2026). It belongs to Section G — Procedures / Professional Services (Temporary). Under Medicare, its coverage status is: Carrier judgment. Part B pricing methodology: Priced by carriers (physician fee schedule).
Classification & CMS Attributes
- Medicare Coverage
- Carrier judgment (code C)
- Part B Pricing
- Priced by carriers (physician fee schedule) (indicator 13)
- Type of Service
- Medical care
- Effective Date
- 2018-10-01
- 2026 Maintenance
- No change this year
References
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Reference G9986 with the canonical source and edition:
G9986 — Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology. ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/G9986
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