Summary & Overview
HCPCS G9007: Coordinated Care Fee for Scheduled Team Conference
HCPCS Level II code G9007 denotes a coordinated care fee for a scheduled team conference, reflecting reimbursement for multidisciplinary care coordination activities outside of direct patient face-to-face procedures. Nationally, this code matters as health systems and payers increasingly recognize structured team conferences as a billable component of comprehensive care management for complex patients. Inclusion of G9007 can influence practice workflows, documentation requirements, and payer agreements when coordination is central to patient outcomes.
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, typical settings where the service is delivered, and which payers recognize the code. The publication summarizes common modifiers and administrative considerations provided in the input and highlights areas where input data was not available.
This piece provides practical benchmarks and policy context: how the code is used for multidisciplinary team conferences, implications for billing teams and revenue cycle operations, and common documentation elements associated with coordinated care fees. If readers need payer-specific rules, coverage nuances, or local implementation guidance, those details may require consultation of payer policy manuals since some information was not available in the input.
Billing Code Overview
HCPCS Level II code G9007 is for Coordinated care fee, scheduled team conference. This code represents a fee associated with multidisciplinary care coordination conducted through a scheduled team conference involving clinical and non-clinical members of a patient's care team.
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Service type: Care coordination via scheduled team conference
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Typical site of service: Outpatient clinic or ambulatory care setting where care teams convene (including virtual conference settings when applicable)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A multidisciplinary outpatient team conducts a scheduled coordinated care conference to review and update a complex patient's care plan. Typical patients include those with multiple chronic conditions (for example, congestive heart failure, diabetes with complications, chronic obstructive pulmonary disease, and advanced-stage cancer) who require input from primary care, specialty physicians, nursing care managers, pharmacy, social work, and rehabilitation services. The conference is scheduled in advance by the clinic or health system and convenes the care team to: review recent hospitalizations or emergency visits, reconcile medications, align specialty recommendations, coordinate home health or durable medical equipment needs, and document a single updated care plan. The patient’s primary care clinician or case manager normally prepares an agenda and relevant records, and the team documents attendees, time spent, decisions made, and follow-up assignments.
Typical site of service: outpatient clinic, physician office, ambulatory care center, or hospital outpatient department where the multidisciplinary team can assemble or connect virtually.
Typical patient scenario: an adult patient with heart failure (symptomatic, recent hospitalization), type 2 diabetes with nephropathy, and mobility limitations. The patient was recently discharged and requires medication adjustment, referral to home health nursing, and coordination of cardiology, endocrinology, pharmacy, and social work to implement a discharge plan. A scheduled team conference lasting 45 minutes is convened to finalize the coordinated care plan and assign responsibilities.
Coding Specifications
| Modifier | Description | When to Use |
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