G8938 HCPCS Level II code: Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible
CMS terminated G8938: its last date of service was Dec 31, 2021. It stays here for looking up older claims; newer services need a current code.
Official description
G8938Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible
Short description: Bmi doc onl fup nt doc
HCPCS · United States
Medicare details
The indicators CMS publishes with G8938 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, 2013
- Terminated after
- Dec 31, 2021
Where G8938 sits
- 1G codesProcedures and professional services
- 2Terminated G8938Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible
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
Is HCPCS code G8938 still valid?
No. CMS terminated G8938; its last date of service was Dec 31, 2021. It is listed for looking up services from before then. Use a current code for newer services.
Does Medicare cover G8938?
CMS lists G8938’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 G8938
All G codesG8932Suicide risk assessed at the initial evaluationG8933Suicide risk not assessed at the initial evaluation, reason not givenG8934Current or prior left ventricular ejection fraction (lvef) <=40% or documentation of moderately or severely depressed left ventricular systolic functionG8935Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapyG8936Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy…G8937Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not givenG8939Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounterG8940Screening for depression documented as positive, a follow-up plan not completed, documented reasonG8941Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounterG8942Functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days…G8943Ldl-c result not present or not within 12 months priorG8944Ajcc melanoma cancer stage 0 through iic melanoma