CG HCPCS Level II modifier: Policy criteria applied
CG is a HCPCS Level II modifier: “Policy criteria applied.” It adds this detail to the code it is reported with.
Official description
CGPolicy criteria applied
HCPCS · United States
Medicare details
The indicators CMS publishes with CG in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Added
- Jul 1, 2008
Where CG sits
- 1GroupHCPCS modifiers
- 2Modifier CGPolicy criteria applied
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code CG mean?
CG is the HCPCS code for “Policy criteria applied” in CMS’s HCPCS Level II October 2026 release.
Where is CG in the HCPCS Level II list?
CG is listed under Modifiers.
Does Medicare cover CG?
CMS lists CG’s Medicare coverage as “Carrier judgment”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside CG
All modifiersCAProcedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admissionCBService ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursableCCProcedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)CDAmcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billableCEAmcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately…CFAmcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billableCH0 percent impaired, limited or restrictedCIAt least 1 percent but less than 20 percent impaired, limited or restrictedCJAt least 20 percent but less than 40 percent impaired, limited or restrictedCKAt least 40 percent but less than 60 percent impaired, limited or restrictedCLAt least 60 percent but less than 80 percent impaired, limited or restrictedCMAt least 80 percent but less than 100 percent impaired, limited or restricted