G9017 Amantadine Oral 100 mg HCPCS Reimbursement

HCPCS Level II code G9017 denotes a 100 mg oral unit of amantadine hydrochloride supplied specifically for use in a Medicare-approved demonstration project. As a demonstration-specific HCPCS Level II code, G9017 is important for tracking medication participation in federally sanctioned research initiatives and for ensuring appropriate billing and reporting within those programs. Nationally, such demonstration project codes affect program accounting, supply chain reporting, and program evaluation rather than routine clinical reimbursement.

Key payers commonly considered in discussions of HCPCS demonstration codes include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical purpose of the code, the typical outpatient/ambulatory sites where the medication would be dispensed, and the implications for billing systems when handling demonstration-project pharmaceuticals. The publication outlines benchmarking considerations, how demonstration-specific HCPCS codes are used distinct from standard outpatient drug codes, and the policy context that governs Medicare-approved demonstration projects.

This summary is intended for administrators, coders, and policy stakeholders seeking concise guidance on the role and national significance of HCPCS Level II code G9017 in demonstration project workflows.

Billing Code Overview

HCPCS Level II code G9017 represents Amantadine hydrochloride, oral, per 100 mg provided for use in a Medicare-approved demonstration project. The service type is oral medication dispensing and administration for a demonstration research program. The typical site of service is outpatient or ambulatory settings where oral pharmaceuticals are dispensed or administered for demonstration projects, including clinic pharmacies and outpatient infusion/medication units.

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Clinical Context

A Medicare beneficiary enrolled in a CMS-approved demonstration project is being treated with oral amantadine hydrochloride for management of Parkinson disease motor symptoms or drug-induced extrapyramidal symptoms. Typical patient is an older adult with established neurologic diagnosis such as Parkinson disease who attends a neurology clinic visit for medication management. The workflow: clinician documents indication, past response to dopaminergic therapy, and rationale for use of amantadine; prescriber writes an order for oral amantadine hydrochloride, documented as G9017 units per 100 mg; pharmacy dispenses medication per the demonstration project protocol; clinician documents follow-up plan and monitors for side effects (confusion, hallucinations, peripheral edema, orthostatic hypotension) and renal function for dose adjustment. Visits may include baseline and periodic medication reconciliation, medication counseling, and assessment of motor function using standard clinical scales.

Coding Specifications

Modifier	Description	When to Use
`24`	Unrelated Evaluation and Management service by the same physician during a postoperative period	Use if an unrelated E/M is provided during a postoperative global period when `G9017` is billed separately as part of medication management outside postoperative care

Taxonomy Code	Specialty	Notes
`207RN0401X`	Neurology	Neurologists commonly manage Parkinson disease and prescribe amantadine for motor symptoms
`207P00000X`	Pharmacy	Pharmacists dispense oral amantadine and provide counseling under the demonstration protocol
`207Q00000X`	Geriatric Medicine	Geriatricians manage medication optimization and adverse effect monitoring in older adults
`2084N0402X`	Internal Medicine	Primary care internists often coordinate chronic neurologic medication management and monitoring
`362X00000X`	Clinical Laboratory	Clinical lab specialists perform renal and metabolic testing relevant to dosing and safety

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G20`	Parkinson disease	Primary indication for amantadine to treat motor fluctuations and dyskinesia in Parkinson disease
`G21.1`	Secondary parkinsonism due to external agents (drug-induced)	Amantadine may be used to treat drug-induced extrapyramidal symptoms and parkinsonism
`G25.4`	Drug-induced tremor	Symptomatic medication such as amantadine can be considered in selected tremor management
`R25.1`	Tremor, unspecified	Symptom code when tremor is present and amantadine is trialed for symptomatic relief
`F02.80`	Dementia in other diseases classified elsewhere without behavioral disturbance	Used when comorbid cognitive impairment requires careful monitoring of amantadine adverse effects
`I10`	Essential (primary) hypertension	Common comorbidity; relevant because amantadine can affect blood pressure and warrants monitoring
`N18.9`	Chronic kidney disease, unspecified	Renal impairment affects amantadine clearance and dosing; important for safe prescribing

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 visit code for follow-up medication management when initiating or adjusting `G9017` therapy
`99214`	Office or other outpatient visit for established patient, typically 25 minutes	Used for more complex medication decisions or when extensive counseling/coordination is required for `G9017`
`81002`	Urinalysis, non-automated, without microscopy	May be performed during medication monitoring to evaluate hydration or infections that can affect therapy tolerance
`80048`	Basic metabolic panel (BMP)	Ordered to assess renal function and electrolytes prior to or during amantadine therapy for dose adjustments
`99406`	Smoking and tobacco use cessation counseling, intermediate, greater than 3 minutes up to 10 minutes	Counseling code sometimes used in comprehensive chronic disease management visits where medication side effect risk is discussed

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Summary & Overview

HCPCS G9017: Amantadine Hydrochloride Oral 100 mg