Summary & Overview

HCPCS G8752: Most Recent Systolic Blood Pressure < 140 mmHg

HCPCS Level II code G8752 represents documentation that a patient’s most recent systolic blood pressure is less than 140 mmHg. This quality-related code is used in outpatient and ambulatory settings to indicate controlled systolic blood pressure and supports clinical quality measurement and reporting nationally. The code matters because systolic blood pressure control is a key metric in chronic disease management, population health programs, and value-based payment models.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, benchmarks for blood pressure control where available, common use cases in ambulatory care, and implications for quality reporting and payer performance measurement. The publication summarizes how G8752 fits into broader hypertension management efforts and quality programs, and outlines what information is available versus what is not provided in the input.

Data not available in the input: associated taxonomies, specific ICD-10 diagnoses, related billing codes, and detailed payer-specific coverage rules.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG8752HCPCS Level IIblood pressurehypertensionquality measureoutpatient careclinical documentationambulatory carepopulation health

Billing Code Overview

HCPCS Level II code G8752 denotes most recent systolic blood pressure < 140 mmHg. This code captures a clinical measurement indicating that a patient's most recent systolic blood pressure reading was below 140 millimeters of mercury.

Service type: Measurement/clinical quality documentation related to blood pressure control
Typical site of service: Ambulatory clinic or outpatient setting where systolic blood pressure is measured and recorded

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A primary care patient with a history of hypertension attends a routine office visit for chronic disease management. The clinician (family medicine physician or nurse practitioner) measures the patient’s blood pressure using an automated or manual sphygmomanometer. The most recent systolic blood pressure reading is documented as less than 140 mmHg and the encounter is coded for blood pressure control monitoring. The clinical workflow includes verifying patient identity, confirming no recent exercise or caffeine intake, positioning the patient correctly, obtaining at least two blood pressure measurements separated by a brief interval if indicated, recording the most recent systolic value in the medical record, and updating the problem list and hypertension management plan. The documented systolic value < 140 mmHg is reported with HCPCS Level II code G8752 for quality reporting and performance measurement during the visit. Typical sites of service are outpatient clinics, physician offices, and community health centers. Typical patient scenario: a 58-year-old patient with essential hypertension on antihypertensive therapy presents for follow-up; medication adherence and side effects are reviewed, lifestyle counseling is briefly reinforced, and the recorded systolic blood pressure is 132 mmHg, qualifying for G8752 reporting.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documentation supports substantially greater physician work than typical for the visit related to complex hypertension management or counseling.
`23`	Unusual anesthesia	Use if general anesthesia is required for an unrelated procedure performed the same day (rarely applicable).
`52`	Reduced services	Use when a service was partially reduced or not completed during the encounter affecting reporting context.
`53`	Discontinued procedure	Use when the visit or related service is discontinued due to patient condition before completion.
`54`	Surgical care only	Use if the reporting clinician provided only surgical care while another clinician manages medical follow-up (rare for BP measurement alone).
`55`	Postoperative management only	Use if reporting clinician only provided postoperative care separate from the office visit that captured the blood pressure.
`56`	Preoperative management only	Use when clinician provided only preoperative evaluation separate from the encounter documenting BP.
`62`	Two surgeons	Use when two surgeons of different specialties perform surgery the same day and the blood pressure measurement is part of perioperative monitoring.
`AS`	Physician assistant services with assistant at surgery	Use when a physician assistant documents BP as an assistant during a surgical episode.
`Q6`	Service furnished under a grant or contract	Use when the service is rendered under a federal grant program that requires this modifier.

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Most common specialty managing chronic hypertension and documenting `G8752`.
`207R00000X`	Internal Medicine	Primary specialty documenting BP control in adult patients.
`363L00000X`	Nurse Practitioner	Common mid-level provider who measures and documents BP in ambulatory settings.
`367A00000X`	Physician Assistant	Often documents vitals and participates in hypertension follow-up care.
`207LP2900X`	Geriatric Medicine	Frequently manages blood pressure control in older adult patients.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I10`	Essential (primary) hypertension	Primary diagnosis associated with routine blood pressure monitoring and control reporting using `G8752`.
`I11.9`	Hypertensive heart disease without heart failure	Hypertensive complications warrant regular BP monitoring and documentation of systolic control.
`I12.9`	Hypertensive chronic kidney disease with stage unspecified	Hypertension with renal involvement requires close BP measurement and management.
`E78.5`	Hyperlipidemia, unspecified	Common comorbidity in patients with hypertension; often addressed during the same outpatient visit.
`Z79.899`	Other long term (current) drug therapy	Used to indicate chronic antihypertensive medication therapy when documenting ongoing management.
`I15.0`	Renovascular hypertension	Secondary hypertension subtype where close BP tracking is clinically important.
`R03.0`	Elevated blood-pressure reading, without diagnosis of hypertension	Used when an elevated reading is documented but hypertension diagnosis not yet established.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M visit code used when BP is assessed and management of hypertension is performed during a routine follow-up.
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, typically 25 minutes	Used for more complex hypertension visits with moderate complexity medical decision making where BP measurement and treatment adjustments occur.
`99211`	Office or other outpatient visit for the evaluation and management of an established patient, minimal service	Used when visit is brief and BP measurement documented without appreciable physician work.
`99406`	Smoking and tobacco-use cessation counseling, intermediate, 3-10 minutes	Often provided alongside hypertension management and BP measurement as part of cardiovascular risk reduction counseling.
`93000`	Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	May be ordered in patients with hypertension as part of cardiovascular evaluation during the same visit.