Quantum Health Services • Code Search
← Back to Code Search

HCPCS G9490

Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code

HCPCS G9490 CMS Temporary Procedures & Professional Services

Description

Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code

Common Specialties

Internal Medicine, Emergency Medicine

Documentation Requirements

  • Document clinical indications and clear medical necessity supporting the encounter or procedure.
  • Ensure complete provider signatures, credentials, date, and specific place of service (POS).
  • Verify documentation strictly supports code specificity to prevent downcoding or claim denials.

Billing & Coding Tips

  • Verify current payer fee schedules, NCCI edits, and Medically Unlikely Edits (MUEs).
  • Append correct modifiers (e.g., 25, 59, 26, TC) where distinct procedural services or components apply.
  • Confirm pre-authorization rules with Medicare, Medicaid, and commercial plans before submission.

Related Codes

G9001 G9002 G9003 G9004 G9005 G9006 G9007 G9008 G9009 G9010 G9011 G9012 G9013 G9014 G9016

Quantum Health Services provides full-cycle revenue cycle management and medical billing services nationwide. This code reference is for educational purposes; always verify official payer policies. CPT© descriptors require proper AMA licensing.