G9561 HCPCS Level II code: Patients prescribed opiates for longer than six weeks
CMS terminated G9561: 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
G9561Patients prescribed opiates for longer than six weeks
Short description: Presc opiates >6 wks
HCPCS · United States
Medicare details
The indicators CMS publishes with G9561 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
- Undefined codes
- Added
- Jan 1, 2016
- Terminated after
- Dec 31, 2021
Where G9561 sits
- 1G codesProcedures and professional services
- 2Terminated G9561Patients prescribed opiates for longer than six weeks
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 G9561 still valid?
No. CMS terminated G9561; 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 G9561?
CMS lists G9561’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 G9561
All G codesG9555Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical…G9556Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging not recommendedG9557Final reports for ct, cta, mri or mra studies of the chest or neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule foundG9558Patient treated with a beta-lactam antibiotic as definitive therapyG9559Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)G9560Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not givenG9562Patients who had a follow-up evaluation conducted at least every three months during opioid therapyG9563Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapyG9572Index date phq-score greater than 9 documented during the twelve month denominator identification periodG9573Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m…G9574Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m…G9577Patients prescribed opiates for longer than six weeks