HCPCS Level II · Procedures and professional services (temporary)
G9521Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months
✓ Active
Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About G9521
G9521 is an HCPCS Level II code in the G series (procedures and professional services (temporary)), describing total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months.
It was added to HCPCS effective 01/01/2016.
Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.
Details
- Short description
- Er and ip hosp <2 in 12 mos
- Date added
- 01/01/2016
- Action effective
- 01/01/2016
- BETOS
- Z2
Related G95xx codes
- G9500Radiation exposure indices documented in final report for procedure using fluoroscopy
- G9501Radiation exposure indices not documented in final report for procedure using fluoroscopy, reason not given
- G9502Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)
- G9504Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy
- G9505Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason
- G9507Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)
- G9508Documentation that the patient is not on a statin medication
- G9509Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5
- G9510Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5
- G9511Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period
- G9512Individual had a pdc of 0.8 or greater
- G9513Individual did not have a pdc of 0.8 or greater
Common questions about G9521
Is HCPCS G9521 still valid?
- Yes. G9521 is active in the CMS October 2026 HCPCS file.
Does Medicare cover G9521?
- Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.