Summary & Overview

HCPCS G9714: Patient Using Hospice Services During Measurement Period

HCPCS Level II code G9714 denotes that a patient received hospice services at any point during the measurement period. This status code is used in quality measurement and reporting to capture hospice utilization, which can affect care pathways, quality metrics, and eligibility for certain interventions. Nationally, accurate capture of hospice use supports measurement integrity for population health programs and informs payer policy and quality evaluations.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, the clinical and service context for hospice documentation, and the types of analyses and reporting where G9714 is relevant. The publication summarizes common reporting uses, typical sites of service (hospice settings including home hospice), and the implications for quality measurement programs.

Where additional structured data is needed for billing or reporting (such as associated taxonomies, ICD-10 diagnoses, or related codes), the input data was not provided. The content focuses on national relevance rather than state-specific rules and prepares readers to interpret G9714 in payer-level reporting and quality measurement workflows.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG9714HCPCS Level IIhospice servicesquality measurementhospice caremeasurement periodreportingend-of-life care

Billing Code Overview

HCPCS Level II code G9714 indicates that a patient is using hospice services any time during the measurement period. This code is used to document hospice enrollment or use during the relevant measurement window.

Service type: Hospice care encounter / hospice services

Typical site of service: Hospice setting or any site where hospice services are provided (including home hospice)

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

Patient is enrolled in hospice care and receives hospice services at any time during the measurement period. A common scenario is an 82-year-old patient with advanced metastatic lung cancer, progressive functional decline, and a decision for comfort-focused care. The patient is admitted to a community hospice program where the interdisciplinary hospice team (physician, nurse, social worker, chaplain, and hospice aide) provides symptom management, psychosocial support, and caregiver education. Billing staff capture hospice eligibility and dates of service and report hospice status using the HCPCS Level II code G9714 to indicate the patient was receiving hospice services during the measurement period. Typical workflow includes confirming hospice enrollment, documenting start and stop dates of hospice care in the medical record, coordinating medication and durable medical equipment coverage through the hospice benefit, and communicating hospice status to primary care and specialty providers involved in the patient’s care.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When additional work beyond typical hospice-related procedures is documented and justifies increased payment for a separately billable service (rare for hospice indicator reporting).
`23`	Unusual anesthesia	When general anesthesia is rendered under unusual circumstances during an otherwise non‑anesthesia procedure (seldom applicable to hospice status reporting).
`52`	Reduced services	When a service is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When a procedure is terminated due to extenuating circumstances or those that threaten patient safety.
`54`	Surgical care only	When only the surgical portion of a procedure is performed (more relevant to operative claims that may coincide with hospice enrollment).
`55`	Postoperative management only	When only postoperative care is billed separate from the initial procedure (occasionally used when ongoing care overlaps with hospice).
`56`	Preoperative management only	When only preoperative care is billed.
`62`	Two surgeons	When two surgeons work together as primary surgeons.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	When an advanced practice clinician serves as an assistant at surgery.
`QX`	CRNA service with medical direction by a physician	When a certified registered nurse anesthetist performs services with physician direction.

Taxonomy Code	Specialty	Notes
`207Q00000X`	Hospice and Palliative Medicine Physician	Leads medical management and goals-of-care planning for hospice patients.
`207R00000X`	Internal Medicine Physician	Common primary physician managing chronic and terminal conditions prior to and during hospice enrollment.
`251S00000X`	Registered Nurse	Provides hospice nursing assessments, symptom management, and documentation relevant to billing.
`251E00000X`	Social Worker	Manages psychosocial assessments and supports caregiver needs, documentation of hospice status.
`332B00000X`	Chaplain/Spiritual Counselor	Provides spiritual care and documents visits that support hospice care plans.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z51.5`	Encounter for palliative care	Commonly used to indicate palliative services and may co-occur with hospice enrollment documentation.
`C34.90`	Malignant neoplasm of unspecified part of bronchus or lung, unspecified	Advanced lung cancer is a frequent diagnosis among hospice enrollees.
`C80.1`	Malignant (primary) neoplasm, unspecified; metastatic disease	Represents advanced metastatic disease often qualifying patients for hospice.
`F03.90`	Unspecified dementia without behavioral disturbance	Dementia with functional decline is a common reason for hospice care.
`I50.9`	Heart failure, unspecified	Advanced heart failure with refractory symptoms can lead to hospice enrollment.
`N18.6`	End stage renal disease	ESRD with limited treatment goals may be managed with hospice services.
`G30.9`	Alzheimer disease, unspecified	Advanced Alzheimer disease frequently results in hospice care for comfort-focused management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99304`	Initial nursing facility assessment and care plan services, typically 30 minutes	May be performed if a hospice patient resides in a nursing facility and requires a comprehensive initial assessment when hospice care begins.
`99307`	Subsequent nursing facility care, per day, for evaluation and management of a patient	Used for ongoing daily or periodic E/M encounters for hospice patients in institutional settings.
`99497`	Advance care planning including explanation and discussion of advance directives, first 30 minutes	Often provided to hospice patients and family to document goals of care and support hospice enrollment decisions.
`99324`	Domiciliary or rest home visit for the evaluation and management of a new patient	Applicable when hospice team performs home-based assessments at the start of hospice services.
`99082`	Educational services related to patient care coordination provided in a group setting	May be used for caregiver training sessions organized by hospice organizations.