G9521 Er and inpatient hosp <2 in 12 mos
Also known as: low utilization, few hospitalizations
Documentation that patient had fewer than two emergency room and inpatient hospitalizations in the previous twelve months.
In Plain Language
patient went to hospital less than twice in the last year
Clinical Context
Healthcare utilization quality measure indicating good disease control and low acute care needs in chronic disease populations.
RVU Information
CPT G9521 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 G9521?
CPT G9521 (Er and inpatient hosp <2 in 12 mos) is a G Codes code. Documentation that patient had fewer than two emergency room and inpatient hospitalizations in the previous twelve months.
Who uses CPT code G9521?
CPT G9521 is used by Care Management, Primary Care, Quality Reporting. Healthcare utilization quality measure indicating good disease control and low acute care needs in chronic disease populations.
When is CPT G9521 used?
Healthcare utilization quality measure indicating good disease control and low acute care needs in chronic disease populations.
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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.