G9685 HCPCS Level II code: Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing…
G9685 is the HCPCS code for “Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a…” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G9685Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a demonstration project
Short description: Acute nursing facility care
HCPCS · United States
Medicare details
The indicators CMS publishes with G9685 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
- Oct 1, 2016
Where G9685 sits
- 1G codesProcedures and professional services
- 2Active code G9685Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a demonstration project
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 G9685 mean?
G9685 is the HCPCS code for “Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a demonstration project” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G9685?
CMS lists G9685’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 G9685
All G codesG9679This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiaryG9680This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiaryG9681This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiaryG9682This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiaryG9683Facility service(s) for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder. (may only be billed once per day per beneficiary). this…G9684This code is for the onsite acute care treatment of a nursing facility resident for a uti; may only be billed once per day per beneficiaryG9686Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing…G9687Hospice services provided to patient any time during the measurement periodG9688Patients using hospice services any time during the measurement periodG9689Patient admitted for performance of elective carotid interventionG9690Patient receiving hospice services any time during the measurement periodG9691Patient had hospice services any time during the measurement period