G9811 — Patient did not achieve a pdc of at least 75% for their asthma controller medication
G9811 is a HCPCS Level II code for patient did not achieve a pdc of at least 75% for their asthma controller medication. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2022 and is not valid on new claims.
This code has been terminated
CMS terminated G9811 on December 31, 2022. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
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.
The CMS record for G9811
- Long descriptor
- Patient did not achieve a pdc of at least 75% for their asthma controller medication
- Short descriptor
- No pdc 75% w/asth cont med
- Added
- January 1, 2017
- Terminated
- December 31, 2022
- 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.
When CMS retired it.
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 G9811
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9811 is not quite right, the correct code is very often within a few positions of it.
- G9803Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for amiterminated
- G9804Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for amiterminated
- G9805Patients who use hospice services any time during the measurement period
- G9806Patients who received cervical cytology or an hpv test
- G9807Patients who did not receive cervical cytology or an hpv test
- G9808Any patients who had no asthma controller medications dispensed during the measurement yearterminated
- G9809Patients who use hospice services any time during the measurement periodterminated
- G9810Patient achieved a pdc of at least 75% for their asthma controller medicationterminated
- G9812Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure
- G9813Patient did not die within 30 days of the procedure or during the index hospitalization
- G9814Death occurring during the index acute care hospitalizationterminated
- G9815Death did not occur during the index acute care hospitalizationterminated
- G9816Death occurring after discharge from the hospital but within 30 days post procedureterminated
- G9817Death did not occur after discharge from the hospital within 30 days post procedureterminated
- G9818Documentation of sexual activity
- G9819Patients who use hospice services any time during the measurement period
Questions about G9811
What is HCPCS code G9811?
G9811 is a HCPCS Level II code for patient did not achieve a pdc of at least 75% for their asthma controller medication. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9811?
The CMS HCPCS file marks G9811 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.
Is G9811 still valid?
No. G9811 was terminated on December 31, 2022 and should not be used on new claims.