Summary & Overview
HCPCS G9926: Safety Concerns Screening, Positive Without Mitigation Recommendations
HCPCS Level II code G9926 denotes a screening encounter in which a patient screens positive for safety concerns and no mitigation recommendations, referrals, or resource connections are provided. Nationally, standardized documentation and coding for safety screenings matter because they support quality measurement, care coordination, and tracking of unmet patient needs across outpatient settings. Clear use of G9926 helps distinguish brief positive screens from encounters that include counseling or referral services, which are coded separately.
Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical intent, guidance on typical settings where it is used, comparisons to related screening services, and context on common billing practices and modifiers. The publication covers benchmark considerations, documentation elements that support correct use, and recent policy updates relevant to national payers.
This overview is intended for billing professionals, compliance officers, clinicians involved in screening workflows, and policy analysts seeking a clear summary of G9926 and its role in coding safety screenings that do not include mitigation recommendations.
Billing Code Overview
HCPCS Level II code G9926 describes a safety concerns screening positive screen without provision of mitigation recommendations, which may include but is not limited to referral to other resources. The service represents a screening interaction where a patient screens positive for one or more safety concerns and no mitigation steps, counseling, or formal referrals are provided as part of the billed encounter.
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Service type: Screening assessment for identified safety concerns without mitigation recommendations
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Typical site of service: Ambulatory clinic, primary care office, outpatient behavioral health setting, or other outpatient screening venues where brief assessments are conducted
Clinical & Coding Specifications
Clinical Context
A primary care clinician or social worker performs a structured safety concerns screening during a routine outpatient visit (telehealth or in-person) for an adult patient with mood disorder symptoms. The screening tool identifies active safety concerns (for example, food insecurity, housing instability, transportation barriers, interpersonal violence, or suicidal ideation) but the clinician documents that no mitigation recommendations, referrals, or resource linkage were provided at that visit. The workflow: intake nurse administers the screening; positive screen is flagged in the chart; clinician reviews results, discusses briefly with the patient, documents the positive screen and rationale for no mitigation actions (patient refusal, time constraints, triage to a later visit, or information-only encounter), and bills G9926 to indicate a positive safety screen without provision of mitigation recommendations. Typical sites of service include outpatient clinics, primary care offices, behavioral health clinics, and telehealth platforms. Typical patient scenario: a 42-year-old patient with generalized anxiety disorder screened positive for housing instability during a scheduled primary care visit; patient declines referral and requests to address housing later, so the clinician documents the positive screen without offering mitigation and bills G9926. Common payors encountered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
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