G8543 HCPCS Level II code: Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given
G8543 is the HCPCS code for “Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G8543Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given
Short description: Cur funct asses; no care pln
HCPCS · United States
Medicare details
The indicators CMS publishes with G8543 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Specialist - other
- Added
- Jan 1, 2009
Where G8543 sits
- 1G codesProcedures and professional services
- 2Active code G8543Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given
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 G8543 mean?
G8543 is the HCPCS code for “Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G8543?
CMS lists G8543’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. 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 G8543
All G codesG8535Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter related to one of the…G8536No documentation of an elder maltreatment screen, reason not givenG8539Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional…G8540Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the…G8541Functional outcome assessment using a standardized tool not documented, reason not givenG8542Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not requiredG8544I intend to report the coronary artery bypass graft (cabg) measures groupG8545I intend to report the hepatitis c measures groupG8547I intend to report the ischemic vascular disease (ivd) measures groupG8548I intend to report the heart failure (hf) measures groupG8549All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patientG8551All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient