Summary & Overview
HCPCS G9479: Hospice Pharmacist Services, 15-Minute Units
HCPCS Level II code G9479 denotes hospice pharmacist services delivered in 15-minute units. This code captures pharmacist-provided clinical activities within the hospice care setting, such as medication review, reconciliation, education, and regimen optimization for patients receiving end-of-life care. Nationally, documenting these services supports clinical coordination, medication safety, and specialized pharmaceutical oversight in hospice programs.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of reimbursement context, common billing practices, and how G9479 maps to hospice service lines and care delivery. The publication highlights benchmarks where available, notes common modifiers used in practice, and outlines the clinical context for pharmacist involvement in hospice teams. The material is intended for billing professionals, hospice program managers, and clinicians seeking a clear summary of the code’s purpose, service setting, and payer coverage considerations.
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Billing Code Overview
HCPCS Level II code G9479 represents services performed by a qualified pharmacist in the hospice setting, billed in 15-minute increments. The service type is pharmacist-provided clinical care focused on medication management and related pharmaceutical services. The typical site of service is the hospice care setting, including inpatient hospice units and hospice services provided in the patient’s residence.
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Clinical & Coding Specifications
Clinical Context
A home hospice patient with advanced metastatic cancer receives a visit from the interdisciplinary hospice team. The patient is experiencing increasing symptom burden including pain and nausea; the hospice physician asks the hospice pharmacist to perform a comprehensive medication review, reconcile all medications, assess potential adverse drug events and drug interactions, optimize symptom-directed regimens (including opioid titration and adjuvant agents), and provide caregiver education. The pharmacist documents each 15-minute block of clinical pharmacist services delivered in the hospice setting, including time spent by phone coordinating with the prescriber, adjusting medication plans, and supplying education to the patient and family. Typical workflow elements include review of the medical record and medication list, assessment of symptom control and side effects, formulation of recommendations to the hospice physician or nurse practitioner, implementation of pharmacist-approved changes under collaborative agreements when applicable, documentation in the hospice medical record, and billing hospice-specific pharmacy time using G9479 in 15-minute increments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When pharmacist time or complexity substantially exceeds usual service for G9479 and payer allows modifier . |