G8856 — Referral to a physician for an otologic evaluation performed
G8856 is a HCPCS Level II code for referral to a physician for an otologic evaluation performed. 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 statusM
Measurement code. Used for reporting purposes only; never paid.
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 G8856
- Long descriptor
- Referral to a physician for an otologic evaluation performed
- Short descriptor
- Ref for oto eval
- Added
- January 1, 2012
- BETOS
- M5B
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G8856
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8856 is not quite right, the correct code is very often within a few positions of it.
- G8848Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)terminated
- G8849Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)
- G8850Positive airway pressure therapy not prescribed, reason not given
- G8851Adherence to therapy was assessed at least annually through an objective informatics system or through self-reporting (if objective reporting is not available, documented)
- G8852Positive airway pressure therapy was prescribedterminated
- G8853Positive airway pressure therapy not prescribedterminated
- G8854Documentation of reason(s) for not objectively reporting adherence to evidence-based therapy (e.g., patients who have been diagnosed with a terminal or advanced disease with an expected life span of less than 6 months, patients who decline therapy, patients who do not return for follow-up at least annually, patients unable to access/afford therapy, patient's insurance will not cover therapy)
- G8855Adherence to therapy was not assessed at least annually through an objective informatics system or through self-reporting (if objective reporting is not available), reason not given
- G8857Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)
- G8858Referral to a physician for an otologic evaluation not performed, reason not given
- G8859Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive daysterminated
- G8860Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive daysterminated
- G8861Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribedterminated
- G8862Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive daysterminated
- G8863Patients not assessed for risk of bone loss, reason not given
- G8864Pneumococcal vaccine administered or previously received
Questions about G8856
What is HCPCS code G8856?
G8856 is a HCPCS Level II code for referral to a physician for an otologic evaluation performed. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8856?
The CMS HCPCS file marks G8856 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 G8856 paid under the physician fee schedule?
G8856 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.