G9011 Mccd, risk adj, level 5
Also known as: CCM level 5 complexity, highest-complexity CCM
Performance measure code for chronic care management services at risk-adjusted level 5 complexity for most complex patients.
In Plain Language
chronic disease management for the most complex patients; CCM for most severe patient cases
Clinical Context
Billing code for Medicare CCM services at the highest complexity level for patients with severe multiple comorbidities.
RVU Information
CPT G9011 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
G-codes are CMS-specific HCPCS codes for services not covered by standard CPT. Documentation requirements follow the same standards as the equivalent CPT service. Check Medicare LCD/NCD policies for coverage criteria.
How This Code Compares
This code has a work RVU of 0.00, meaning it does not have a physician work component assigned by CMS. In the G Codes category, 85% of codes share this characteristic.
Specialties
Frequently Asked Questions
What is CPT code G9011?
CPT G9011 (Mccd, risk adj, level 5) is a G Codes code. Performance measure code for chronic care management services at risk-adjusted level 5 complexity for most complex patients.
Who uses CPT code G9011?
CPT G9011 is used by Primary Care, Care Coordination, Billing. Billing code for Medicare CCM services at the highest complexity level for patients with severe multiple comorbidities.
When is CPT G9011 used?
Billing code for Medicare CCM services at the highest complexity level for patients with severe multiple comorbidities.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.