G8865 HCPCS Level II code: Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug…
G8865 is the HCPCS code for “Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G8865Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)
Short description: Doc med reas no pneumococcal
HCPCS · United States
Medicare details
The indicators CMS publishes with G8865 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 - psychiatry
- Added
- Jan 1, 2012
Where G8865 sits
- 1G codesProcedures and professional services
- 2Active code G8865Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)
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 G8865 mean?
G8865 is the HCPCS code for “Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G8865?
CMS lists G8865’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 G8865
All G codesG8859Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive daysG8860Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive daysG8861Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than…G8862Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive daysG8863Patients not assessed for risk of bone loss, reason not givenG8864Pneumococcal vaccine administered or previously receivedG8866Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)G8867Pneumococcal vaccine not administered or previously received, reason not givenG8868Patients receiving a first course of anti-tnf therapyG8869Patient has documented immunity to hepatitis b and initiating anti-tnf therapyG8870Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapyG8871Patient not receiving a first course of anti-tnf therapy