HCPCS Code G0069

Official Description

Professional services for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes

Short Descr	Adm sq infusion drug in home
Coverage	Special coverage instructions apply
Pricing Indicator(s)	11 – Physician Fee Schedule - Price established using national RVUs
MPI	A – Not applicable, as HCPCS priced under one methodology
Processing Note	THESE G CODES ARE ASSOCIATED WITH A NEW PART B BENEFIT CATEGORY ESTABLISHED BY THE FOLLOWING SECTIONS IN THE SOCIAL SECURITY ACT: 1861(s)(2)(GG), 1861(iii), 1834(u).
BETOS	M4A – Home visit
TOS Code(s)	1 – Medical care
Added Date	1/1/2019
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Service Paid under Fee Schedule or Payment System other than OPPS
MUE	Not applicable/unspecified.
MUE	Not applicable/unspecified.
OTS Orthotic	No

KX	Requirements specified in the medical policy have been met
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit