G8942

G8942 — Functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days of the functional outcome assessment

Q: What is HCPCS code G8942?

G8942 is a HCPCS Level II code for functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days of the functional outcome assessment. It sits in the Procedures and Professional Services (Temporary) section.

Q: Does Medicare cover G8942?

The CMS HCPCS file marks G8942 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.

Q: How is G8942 paid under the physician fee schedule?

G8942 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.

HCPCSActiveBETOS M5B

G8942 is a HCPCS Level II code for functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days of the functional outcome assessment. 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 G8942

Long descriptor: Functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days of the functional outcome assessment
Short descriptor: Doc fcn/care plan w/30 days
Added: January 1, 2013
BETOS: M5B
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to G8942

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8942 is not quite right, the correct code is very often within a few positions of it.

G8934Current or prior left ventricular ejection fraction (lvef) <=40% or documentation of moderately or severely depressed left ventricular systolic function
G8935Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy
G8936Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (eg, patient declined, other patient reasons)
G8937Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given
G8938Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligibleterminated
G8939Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounterterminated
G8940Screening for depression documented as positive, a follow-up plan not completed, documented reasonterminated
G8941Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounterterminated
G8943Ldl-c result not present or not within 12 months priorterminated
G8944Ajcc melanoma cancer stage 0 through iic melanoma
G8946Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)
G8947One or more neuropsychiatric symptomsterminated
G8948No neuropsychiatric symptomsterminated
G8949Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes)terminated
G8950Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented
G8951Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligibleterminated

Questions about G8942

What is HCPCS code G8942?

G8942 is a HCPCS Level II code for functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days of the functional outcome assessment. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G8942?

The CMS HCPCS file marks G8942 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 G8942 paid under the physician fee schedule?

G8942 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.