G9985 HCPCS Level II code: Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement…

G9985 is the HCPCS code for “Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology” in CMS’s HCPCS Level II October 2026 release.

CMS lists G9985’s Medicare coverage as “Carrier judgment” and its pricing as “Physician fee schedule – Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.

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.