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    v1.0.28
    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-g9487-remote-in-home-evaluation-management-established-patient
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    HCPCS G9487: Remote In-Home E/M for Established Patient, 15 min

    Medicare pays $36 on average nationally for this procedure.

    HCPCS Level II code G9487 describes a remote in-home evaluation and management visit for an established patient delivered via real-time interactive audio and video; the service requires at least two of three key components (an expanded problem focused history, an expanded problem focused examination, or medical decision making of low complexity), typically involves counseling and coordination of care, addresses problems of low to moderate severity, and is usually about 15 minutes in duration with the site of service being the patient’s home conducted through telehealth technology as part of a Medicare Innovation Center demonstration project.

    For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing.

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    Clinical & Coding Specifications

    Clinical Context

    An established Medicare beneficiary enrolled in a CMS Innovation Center demonstration has a scheduled remote in‑home visit using real‑time interactive audio and video technology for evaluation and management. The patient is a 72‑year‑old with stable congestive heart failure and new mild dyspnea and peripheral edema over two days. The clinician (primary care physician or advanced practice provider) connects using a secure telehealth platform; the encounter lasts about 15 minutes. The clinician obtains an expanded problem‑focused history (review of systems focused on cardiopulmonary and fluid status), performs an expanded problem‑focused visual examination via video (inspecting respiratory effort, jugular venous distension, ankle edema, and medication bottles), and completes medical decision making of low complexity (adjustment of diuretic dose, counseling on home weight monitoring, and plan for urgent in‑person follow‑up if symptoms worsen). Counseling and coordination of care occur in real time with the patient and caregiver and may include brief outreach to the patient’s cardiologist or home health agency to update therapy and arrange a next‑day home nursing visit. The service is furnished in the patient’s home and documented as a remote in‑home interactive audio/video E/M under G9487 with time, modality, key components met, participants, and follow‑up plan recorded in the medical record.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99453Remote monitoring setup and patient education on use of equipmentMay precede G9487 when remote physiologic monitoring devices are provided to the patient at home.
    99457Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/time per monthMay be performed alongside telehealth E/M for ongoing monitoring and management of chronic conditions.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesClinical content and time may be similar to G9487 for in‑person care; used when in‑clinic follow‑up occurs instead of telehealth.
    99441Telephone evaluation and management service by a physician or other qualified health care professional, 5–10 minutesMay be used for simpler follow‑up by telephone when audio‑only care is appropriate and permitted by payor.
    99091Collection and interpretation of physiologic data digitally stored and/or transmitted by the patientSupports data review that supplements the remote in‑home E/M encounter.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    363LF0000XFamily Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    3336M0002XMail Order PharmacyA pharmacy where pharmacists compound or dispense prescriptions or other medications in accordance with federal and state law, using common carriers t…
    225C00000XRehabilitation CounselorAn individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabil…
    261QX0200XOncology Clinic/CenterAn entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Servic…
    2084P0804XChild & Adolescent Psychiatry PhysicianChild & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, beh…

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    7 rows

    PolicyPayerEffective Date
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01
    Celiac Disease TestingOscar Health2026-10-01

    Related Codes

    HCPCS-G9490-HOME-ASSESSMENT-NON-HOMEBOUND

    HCPCS G9490: Home Visit Patient Assessment for Non-Homebound Beneficiary

    HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

    HCPCS G0008: Administration of Influenza Virus Vaccine

    HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

    HCPCS G0009: Administration of Pneumococcal Vaccine

    HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

    HCPCS G0010: Administration of Hepatitis B Vaccine

    HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

    HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

    HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

    HCPCS G0012: Injection of PrEP Drug for HIV Prevention

    HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

    HCPCS G0013: Individual PrEP Counseling by Clinical Staff

    HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

    HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

    HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

    HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

    HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

    HCPCS G0019: Community Health Integration, Person-Centered Assessment

    Showing 1–10 of 1996

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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