GJ HCPCS Level II modifier: "opt out" physician or practitioner emergency or urgent service
GJ is a HCPCS Level II modifier: “"opt out" physician or practitioner emergency or urgent service.” It adds this detail to the code it is reported with.
Official description
GJ"opt out" physician or practitioner emergency or urgent service
Short description: Opt out provider of er srvc
HCPCS · United States
Medicare details
The indicators CMS publishes with GJ in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Added
- Oct 1, 1998
Where GJ sits
- 1GroupHCPCS modifiers
- 2Modifier GJ"opt out" physician or practitioner emergency or urgent service
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 GJ mean?
GJ is the HCPCS code for “"opt out" physician or practitioner emergency or urgent service” in CMS’s HCPCS Level II October 2026 release.
Where is GJ in the HCPCS Level II list?
GJ is listed under Modifiers.
Does Medicare cover GJ?
CMS lists GJ’s Medicare coverage as “Carrier judgment”. 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 GJ
All modifiersGCThis service has been performed in part by a resident under the direction of a teaching physicianGDUnits of service exceeds medically unlikely edit value and represents reasonable and necessary servicesGEThis service has been performed by a resident without the presence of a teaching physician under the primary care exceptionGFNon-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant…GGPerformance and payment of a screening mammogram and diagnostic mammogram on the same patient, same dayGHDiagnostic mammogram converted from screening mammogram on same dayGKReasonable and necessary item/service associated with a ga or gz modifierGLMedically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)GMMultiple patients on one ambulance tripGNServices delivered under an outpatient speech language pathology plan of careGOServices delivered under an outpatient occupational therapy plan of careGPServices delivered under an outpatient physical therapy plan of care