HCPCS G9802: Patients Using Hospice Services Any Time During Measurement Period - OpenPayer

Summary & Overview

HCPCS G9802: Patients Using Hospice Services Any Time During Measurement Period

HCPCS Level II code G9802 denotes patients who use hospice services at any point during the measurement period. Nationally, this code is important for identifying hospice utilization in quality measurement, care coordination, and reporting of end-of-life service delivery. It helps payers and providers track hospice engagement for populations under value-based and quality programs and can influence population health management strategies.

Key payers in scope for this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what G9802 represents, how it is used in measurement frameworks, and its relevance to clinical workflows and reporting. The publication outlines typical sites of service where hospice care is delivered and summarizes common billing considerations tied to hospice identification. It also highlights available benchmarks and policy updates where applicable, and provides context for clinical teams and administrators regarding hospice service capture and reporting.

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

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG9802HCPCS Level IIhospiceend-of-life carequality measurementpalliative careservice utilizationbilling codecare coordination

Billing Code Overview

HCPCS Level II code G9802 represents patients who use hospice services any time during the measurement period. This code is used to identify individuals who received hospice care during the reporting interval and is categorized under services related to end-of-life and palliative care.

Service type: Hospice services
Typical site of service: Hospice settings, which may include inpatient hospice facilities, hospice inpatient units within hospitals, home hospice care, and long-term care or skilled nursing facilities where hospice services are provided.

Data not available in the input for payers beyond those listed, associated taxonomies, and ICD-10 diagnoses.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves an adult with a terminal illness (for example, advanced metastatic cancer or end-stage chronic obstructive pulmonary disease) who elects hospice care. During the measurement period the patient is enrolled in a hospice program either in their home, an assisted living facility, a nursing home, or an inpatient hospice unit. The clinical workflow begins with the patient or family requesting hospice services or a clinician documenting hospice eligibility based on life-limiting illness and prognosis. The hospice interdisciplinary team performs an initial visit to establish the plan of care, documents enrollment dates and goals of care, and provides ongoing symptom management, psychosocial support, and bereavement services. Billing uses indicator G9802 to denote that the patient used hospice services at any time during the measurement period for quality reporting and payer reconciliation. Typical site of service includes home health/hospice in the home, hospice inpatient units, nursing facilities, and hospital inpatient hospice units. Common scenarios include transition from aggressive disease-directed therapy to comfort-focused care, an admission to a hospice inpatient unit for symptom crisis, or ongoing routine home hospice visits documented by the hospice agency during the measurement period.

Coding Specifications

Modifier	Description	When to Use
`23`	Unusual Anesthesia

HCPCS G0478: Presumptive Drug Test by Instrument-Assisted Observation

HCPCS-G8673-NECK-CRANIUM-MANDIBLE-THORACIC-SPINE-FUNCTIONAL-RESIDUAL-SCORE-NOT-MEASURED

HCPCS G8673: Risk-Adjusted Functional Status Residual Score Not Measured

HCPCS-G8975-NON-RENAL-ANEMIA-DOCUMENTATION-HGB-LT-10

HCPCS G8975: Documentation of Non-Renal Anemia (Hgb < 10 g/dl)

HCPCS-G8949-DIET-PHYSICAL-ACTIVITY-COUNSELING-REFUSAL

HCPCS G8949: Documentation of Diet and Physical Activity Counseling Refusal

HCPCS-G9957-NO-COMBO-PROPHYLACTIC-ANTI-EMETIC-THERAPY-REASON

HCPCS G9957: Documentation for Not Receiving Combination Prophylactic Anti-Emetic Therapy

HCPCS-G9381-END-OF-LIFE-ASSISTANCE-NOT-OFFERED-DOCUMENTATION

HCPCS G9381: Documentation of Reasons for Not Offering End-of-Life Assistance

HCPCS-G8955-ASSESSMENT-ADEQUACY-VOLUME-MANAGEMENT

HCPCS G8955: Assessment of Adequacy of Volume Management

HCPCS-G8654-HIP-PROM-NOT-COMPLETED-RESIDUAL-SCORE-UNAVAILABLE

HCPCS G8654: Hip PROM Not Completed, Residual Score Unavailable

HCPCS-G9882-MDPP-ONGOING-MAINTENANCE-SESSIONS-MONTHS-13-15-5PCT-WEIGHT-LOSS

HCPCS G9882: MDPP Ongoing Maintenance Sessions, Months 13–15

HCPCS-G0665-TEAM-REMOTE-EVALUATION-MANAGEMENT-10MIN

HCPCS G0665: Team Remote E/M for Established Patient, 10 Minutes

Showing 1–10 of 1996

Taxonomy Code	Specialty	Notes
`335800000X`	Hospice and Palliative Medicine	Primary specialty providing and certifying hospice eligibility and ongoing hospice care.
`207Q00000X`	Family Medicine	Common referring or coordinating specialty for hospice enrollment and community-based care.
`207R00000X`	Internal Medicine	Frequent certifying and managing specialty for adult patients transitioning to hospice.
`261QM1300X`	Nurse Practitioner	Advanced practice clinicians who provide hospice visits and ongoing symptom management.
`363L00000X`	Home Health Agency	Organizations that provide home-based hospice services and submit billing including hospice indicators.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99377`	Physician certification and recertification for hospice care, per encounter	Used for documenting and billing the formal hospice certification or recertification visit when hospice enrollment occurs.
`99378`	Hospice care supervision, per 30-day period (physician)	Represents periodic supervision visits by a physician for patients under hospice care during the measurement period.
`99324`	Subsequent hospital care, per day, for evaluation and management of a patient, typically used in inpatient hospice settings	May be billed for daily management of an inpatient hospice patient when documenting active care during a measurement period.
`99341`	Home visit for evaluation and management of a new patient	Used when hospice clinicians perform an initial home visit to evaluate and enroll a patient into hospice services.
`G0154`	Services of a hospice aide in the home health or hospice setting, per visit	Commonly provided alongside hospice enrollment to deliver direct patient care services at home.

OpenPayer