G8561

G8561 — Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure

HCPCSActiveBETOS M5D

G8561 is a HCPCS Level II code for patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.

Medicare coverage: Carrier judgment

Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.

Physician fee schedule statusI

Not valid for Medicare purposes. Medicare uses another code.

Global period: XXX

Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.

The CMS record for G8561

Long descriptor: Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure
Short descriptor: Pt inelig for ref oto eval
Added: January 1, 2010
BETOS: M5D
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to G8561

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8561 is not quite right, the correct code is very often within a few positions of it.

G8545I intend to report the hepatitis c measures groupterminated
G8547I intend to report the ischemic vascular disease (ivd) measures groupterminated
G8548I intend to report the heart failure (hf) measures groupterminated
G8549All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patientterminated
G8551All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patientterminated
G8552All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patientterminated
G8559Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation
G8560Patient has a history of active drainage from the ear within the previous 90 days
G8562Patient does not have a history of active drainage from the ear within the previous 90 days
G8563Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
G8564Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)
G8565Verification and documentation of sudden or rapidly progressive hearing loss
G8566Patient is not eligible for the "referral for otologic evaluation for sudden or rapidly progressive hearing loss" measure
G8567Patient does not have verification and documentation of sudden or rapidly progressive hearing loss
G8568Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
G8569Prolonged postoperative intubation (> 24 hrs) required

Questions about G8561

What is HCPCS code G8561?

G8561 is a HCPCS Level II code for patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G8561?

The CMS HCPCS file marks G8561 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

How is G8561 paid under the physician fee schedule?

G8561 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.