Summary & Overview
HCPCS G9718: Hospice Services During Measurement Period
HCPCS Level II code G9718 denotes that a patient received hospice services at any time during a specified measurement period. This single-code indicator is nationally relevant for quality measurement, population health reporting, and claims-based identification of end-of-life care patterns. It is commonly used in performance metrics and care coordination workflows to flag hospice involvement in a patient’s care during reporting windows.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s purpose, common use cases in claims and quality measurement, and how it fits into hospice service reporting. The publication outlines benchmarks and reporting contexts where G9718 is applied, summarizes payer coverage considerations, and notes areas where input data are not available for this code.
This summary is intended for a national audience of health plan analysts, revenue cycle professionals, quality measurement specialists, and policy stakeholders who need a clear description of the code’s clinical and reporting role.
Billing Code Overview
HCPCS Level II code G9718 represents hospice services for a patient provided any time during the measurement period. This code is used to indicate that a patient received hospice care at any point within the reporting or measurement timeframe.
-
Service type: Hospice care services
-
Typical site of service: Hospice settings, which may include inpatient hospice facilities, hospice units within hospitals, long-term care facilities, and home hospice care
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult enrolled in hospice care due to a terminal illness (for example, advanced metastatic cancer, end-stage heart failure, end-stage chronic obstructive pulmonary disease, or advanced neurodegenerative disease). During the measurement period the patient receives hospice services from a hospice agency or interdisciplinary hospice team; services may include routine home visits by nurses, social work and chaplain support, symptom management, medication and equipment delivery, or continuous home care during episodes of acute symptom burden. The clinical workflow begins with hospice admission documentation (prognosis, election of hospice, comprehensive assessment), ongoing certified visits and notes by hospice clinicians, interdisciplinary team meetings documenting goals of care and services delivered, and disposition or recertification documentation. Billing is reported with the hospice-specific indicator G9718 to denote that hospice services were provided at any time during the measurement period; encounter documentation and start/stop dates of hospice eligibility are maintained in the medical record to support the claim.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When hospice furnishes substantially greater services than typical and payer allows modifier for ancillary professional claims (rare for hospice administrative use) |