G9313 HCPCS Level II code: Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason
G9313 is the HCPCS code for “Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G9313Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason
Short description: Amoxic not presc as 1st line
HCPCS · United States
Medicare details
The indicators CMS publishes with G9313 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, 2014
Where G9313 sits
- 1G codesProcedures and professional services
- 2Active code G9313Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason
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 G9313 mean?
G9313 is the HCPCS code for “Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G9313?
CMS lists G9313’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 G9313
All G codesG9307No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedureG9308Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedureG9309No unplanned hospital readmission within 30 days of principal procedureG9310Unplanned hospital readmission within 30 days of principal procedureG9311No surgical site infectionG9312Surgical site infectionG9314Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not givenG9315Amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosisG9316Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk…G9317Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk…G9318Imaging study named according to standardized nomenclatureG9319Imaging study not named according to standardized nomenclature, reason not given