Summary & Overview
HCPCS Level II G9723: Hospice Services During Measurement Period
HCPCS Level II code G9723 identifies patients who received hospice services at any point during a specified measurement period. This indicator captures utilization of hospice care across settings and is used in quality reporting and population health measurement to flag exposure to end-of-life or palliative services. Nationally, tracking hospice encounters is important for care coordination, billing reconciliation, and reporting requirements tied to quality measures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how G9723 is used in administrative records, the implications for claims processing and quality measurement, and the common contexts in which the code appears in hospice care workflows. The publication outlines typical benchmarks and reporting considerations, summarizes relevant policy updates affecting hospice reporting, and provides clinical context for interpreting hospice-service indicators on claims.
This summary is intended for a national audience of payers, providers, and compliance personnel seeking clarity on the role of G9723 in administrative and quality reporting, and what to expect when hospice services are recorded during a measurement period.
Billing Code Overview
HCPCS Level II code G9723 represents hospice services provided to a patient at any time during the measurement period. The code denotes the occurrence of hospice care during the reporting interval rather than a specific procedure or encounter detail.
Service Type: Hospice care / palliative services
Typical Site of Service: Hospice setting or any site where hospice services are delivered (including inpatient hospice, hospice inpatient units, nursing homes, or home hospice)
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a life-limiting illness (for example, advanced metastatic cancer, end-stage heart failure, or terminal chronic obstructive pulmonary disease) who receives hospice services at any point during the measurement period. The clinical workflow begins when the patient or caregiver expresses desire for comfort-focused care or when the treating physician documents that curative treatments are no longer appropriate. A hospice eligibility evaluation is completed, including documentation of terminal prognosis (generally six months or less if the disease follows its usual course), goals of care discussion, and consent to hospice care. Hospice services in this scenario may be delivered in the home, assisted living facility, nursing facility, or inpatient hospice unit and include interdisciplinary visits (nursing, social work, chaplaincy), symptom management, medication management, durable medical equipment related to comfort, and 24/7 on-call support. Billing for hospice services is reported under the HCPCS Level II code G9723 to indicate the patient received any hospice services during the measurement period.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services | Use when services are substantially greater in complexity or time than normally required for hospice-related procedures or significant additional documentation supports increased effort (rare for hospice global billing but applicable to separately billable services when allowed). |