Summary & Overview
HCPCS G9707: Patient Received Hospice Services During Measurement Period
HCPCS Level II code G9707 denotes that a patient received hospice services at any time during the measurement period. This designation is used in quality measurement and reporting to capture hospice enrollment or receipt of hospice care, which has implications for care planning, outcomes measurement, and payment attribution for populations receiving palliative-focused services. Nationally, tracking hospice receipt is important for measures of end-of-life care quality and for identifying cohorts excluded from certain performance metrics.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis covers payer inclusion of the code in measure reporting and how hospice status is represented across major commercial and public payers.
Readers will learn the clinical context of hospice documentation using G9707, the typical sites where hospice services are delivered, and how the code functions within measurement frameworks. The publication includes benchmarks and reporting guidance where available, summaries of payer handling of hospice-identified patients, and relevant policy considerations affecting hospice documentation in quality measurement. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code G9707 indicates that a patient received hospice services at any time during the measurement period. This code is used to document hospice enrollment or receipt of hospice care for the patient population being measured.
-
Service type: Hospice services (care focused on comfort and palliative support rather than curative treatment)
-
Typical site of service: Hospice care settings, which may include inpatient hospice facilities, hospice units in hospitals, hospice agencies providing home-based hospice care, and other locations where hospice services are delivered.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A patient with a life-limiting illness enrolled in hospice care is admitted to hospice services during the measurement period. Typical patients are older adults with advanced progressive disease such as metastatic cancer, end-stage heart failure, end-stage chronic obstructive pulmonary disease, or advanced dementia who choose comfort-focused care rather than curative treatment. The clinical workflow begins when the treating physician certifies terminal illness and the patient elected hospice; hospice services are initiated by a hospice interdisciplinary team (physician, nurse, social worker, chaplain, and hospice aide). Documentation includes the hospice election form, physician certification and recertifications of hospice eligibility, an individualized plan of care, symptom management notes, and encounter records showing services provided during the measurement period. Billing is submitted with HCPCS Level II code G9707 to indicate the patient received hospice services at any time during the measurement period; supporting encounter notes and hospice documentation substantiate the claim.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Used when services required substantially greater work than typical and documentation supports the increased complexity of hospice-related procedures or evaluations |