G9396 — Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)
G9396 is a HCPCS Level II code for patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days). 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
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The CMS record for G9396
- Long descriptor
- Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)
- Short descriptor
- Ini phq9 >9 not assess
- 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 G9396
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9396 is not quite right, the correct code is very often within a few positions of it.
- G9386Screening for hcv infection not received within the 12 month reporting period, reason not given
- G9389Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgeryterminated
- G9390No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgeryterminated
- G9391Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visitterminated
- G9392Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visitterminated
- G9393Patient with an initial phq-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score of less than five
- G9394Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period
- G9395Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five
- G9399Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatmentterminated
- G9400Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasonsterminated
- G9401No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatmentterminated
- G9402Patient received follow-up within 30 days after dischargeterminated
- G9403Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)terminated
- G9404Patient did not receive follow-up within 30 days after dischargeterminated
- G9405Patient received follow-up within 7 days after dischargeterminated
- G9406Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)terminated
Questions about G9396
What is HCPCS code G9396?
G9396 is a HCPCS Level II code for patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9396?
The CMS HCPCS file marks G9396 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 G9396 paid under the physician fee schedule?
G9396 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.