G9368 — At least two orders for high-risk medications from the same drug class not ordered
G9368 is a HCPCS Level II code for at least two orders for high-risk medications from the same drug class not ordered. 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 G9368
- Long descriptor
- At least two orders for high-risk medications from the same drug class not ordered
- Short descriptor
- >= 2 same hi-rsk med not ord
- Added
- January 1, 2015
- BETOS
- Z2
- 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 G9368
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9368 is not quite right, the correct code is very often within a few positions of it.
- G9360No documentation of negative or managed positive tb screenterminated
- G9361Medical indication for delivery by cesarean birth or induction of labor (<39 weeks of gestation) [documentation of reason(s) for elective delivery (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes (premature or prolonged), maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]
- G9362Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia recordterminated
- G9363Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia recordterminated
- G9364Sinusitis caused by, or presumed to be caused by, bacterial infection
- G9365One high-risk medication orderedterminated
- G9366One high-risk medication not orderedterminated
- G9367At least two orders for high-risk medications from the same drug class
- G9369Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greaterterminated
- G9370Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greaterterminated
- G9376Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgeryterminated
- G9377Patient did not have the retina attached after 6 months following only one surgeryterminated
- G9378Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)terminated
- G9379Patient did not achieve flat retinas six months post surgeryterminated
- G9380Patient offered assistance with end of life issues or existing end of life plan was reviewed or updated during the measurement period
- G9381Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement periodterminated
Questions about G9368
What is HCPCS code G9368?
G9368 is a HCPCS Level II code for at least two orders for high-risk medications from the same drug class not ordered. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9368?
The CMS HCPCS file marks G9368 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 G9368 paid under the physician fee schedule?
G9368 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.