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HCPCS G9001 · Level II · G code

G9001: Coordinated care fee, initial rate, HCPCS Level II G code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file.

Key facts for G9001

Medicare payment
no PFS amount
PFS status X
Coverage code
D
special coverage instructions apply
MUE
none published
no MUE in the 2026 Q4 tables
OPPS status
SI B
Non-allowed item or service for OPPS
NCCI PTP pairs
0
0 hospital outpatient
LCDs and articles
0 / 0

TL;DR

CMS describes HCPCS G9001, added in 2000, as "Coordinated care fee, initial rate". The physician fee schedule lists G9001 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. G9001 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD. OPPS status indicator B: Non-allowed item or service for OPPS. HCPCS record: BETOS Y2 (other - non-Medicare fee schedule); pricing indicator 00; type of service 1 (medical care). 10 other active codes open with "Coordinated care fee"; related codes: G9002, G9003, G9004, G9005.

G9001 descriptor and code status

The October 2026 HCPCS Level II file describes G9001 as “Coordinated care fee, initial rate”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.

HCPCS file attributes of G9001
FieldValue
Short descriptorMccd, initial rate
Added to HCPCS2000-10-01
Last actionN (no maintenance), effective 2000-10-01
Coverage codeD: special coverage instructions apply
Pricing indicator00: not separately priced by Part B
BETOS categoryY2: other - non-Medicare fee schedule
Type of service1: medical care

Medicare payment for G9001

The physician fee schedule lists G9001 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator B (Non-allowed item or service for OPPS), with no separate OPPS payment rate.

Medically Unlikely Edits for G9001

CMS publishes no MUE for G9001 in the 2026 Q4 practitioner, facility or DME supplier tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the quantity furnished on every claim.

The MUE lookup for G9001 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists G9001 in v323r0.

G9001 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check G9001 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G9001

No current LCD or billing and coding article lists G9001. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on G9001

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units exceed what the payer considers medically likely for one date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

For teams evaluating QuickIntell software

Where QuickIntell fits for G9001 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G9001 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-up
Book a software demoAsk about a software workflow

Optional software evaluation, not payer support or help with an individual claim. For coverage or payment decisions, use the official sources on this page. Do not include patient information in a demo booking or inquiry.

Frequently asked questions: HCPCS G9001

What does HCPCS code G9001 describe?

"Coordinated care fee, initial rate" (short descriptor "Mccd, initial rate"), in the G section (procedures and professional services, temporary). Added 2000-10-01.

Is G9001 a CPT code?

It is not. G9001 belongs to the G section (procedures and professional services, temporary) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for G9001?

The physician fee schedule lists G9001 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it.

Does Medicare cover G9001?

G9001 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.