G9696 — Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., patient intolerance or history of side effects)
G9696 is a HCPCS Level II code for documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., patient intolerance or history of side effects). 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 G9696
- Long descriptor
- Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., patient intolerance or history of side effects)
- Short descriptor
- Med rsn no presc bronchdil
- Added
- January 1, 2017
- 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 G9696
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9696 is not quite right, the correct code is very often within a few positions of it.
- G9688Patients using hospice services any time during the measurement period
- G9689Patient admitted for performance of elective carotid intervention
- G9690Patient receiving hospice services any time during the measurement period
- G9691Patient had hospice services any time during the measurement period
- G9692Hospice services received by patient any time during the measurement period
- G9693Patient use of hospice services any time during the measurement period
- G9694Hospice services utilized by patient any time during the measurement period
- G9695Long-acting inhaled bronchodilator prescribed
- G9697Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilatorterminated
- G9698Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., cost of treatment or lack of insurance)
- G9699Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified
- G9700Patients who use hospice services any time during the measurement period
- G9701Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was establishedterminated
- G9702Patients who use hospice services any time during the measurement period
- G9703Episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date
- G9704Ajcc breast cancer stage i: t1 mic or t1a documented
Questions about G9696
What is HCPCS code G9696?
G9696 is a HCPCS Level II code for documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., patient intolerance or history of side effects). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9696?
The CMS HCPCS file marks G9696 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 G9696 paid under the physician fee schedule?
G9696 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.