HCPCS Service Codes - Medical care

HCPCS Service Code 1 for Medical care.

HCPCS Type of Service (TOS) code is an indicator that the contractor places on Form CMS-1500. The indicator is mainly used for data purposes, however in some instances, it affects payment. All HCPCS codes have a corresponding TOS indicator.

Below are all available HCPCS TOS codes. Find an HCPCS code based on the type of service.

HCPCS Codes for Medical care

  • G8420

    Bmi is documented within normal parameters and no follow-up plan is required

  • G8421

    Bmi not documented and no reason is given

  • G8422

    Bmi not documented, documentation the patient is not eligible for bmi calculation

  • G8427

    Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications

  • G8428

    Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given

  • G8430

    Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status)

  • G8431

    Screening for depression is documented as being positive and a follow-up plan is documented

  • G8432

    Depression screening not documented, reason not given

  • G8433

    Screening for depression not completed, documented patient or medical reason

  • G8442

    Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter

  • G8450

    Beta-blocker therapy prescribed

  • G8451

    Beta-blocker therapy for lvef <=40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons)

  • G8452

    Beta-blocker therapy not prescribed

  • G8458

    Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)

  • G8460

    Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c

  • G8461

    Patient receiving antiviral treatment for hepatitis c during the measurement period

  • G8464

    Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined

  • G8465

    High or very high risk of recurrence of prostate cancer

  • G8473

    Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed

  • G8474

    Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons)

  • G8475

    Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given

  • G8476

    Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg

  • G8477

    Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg

  • G8478

    Blood pressure measurement not performed or documented, reason not given

  • G8482

    Influenza immunization administered or previously received

  • G8483

    Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)

  • G8484

    Influenza immunization was not administered, reason not given

  • G8485

    I intend to report the diabetes mellitus (dm) measures group

  • G8486

    I intend to report the preventive care measures group

  • G8487

    I intend to report the chronic kidney disease (ckd) measures group

  • G8489

    I intend to report the coronary artery disease (cad) measures group

  • G8490

    I intend to report the rheumatoid arthritis (ra) measures group

  • G8491

    I intend to report the hiv/aids measures group

  • G8492

    I intend to report the perioperative care measures group

  • G8493

    I intend to report the back pain measures group

  • G8494

    All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient

  • G8495

    All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient

  • G8496

    All quality actions for the applicable measures in the preventive care measures group have been performed for this patient

  • G8497

    All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient

  • G8498

    All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient

  • G8499

    All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient

  • G8500

    All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient

  • G8501

    All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient

  • G8502

    All quality actions for the applicable measures in the back pain measures group have been performed for this patient

  • G8506

    Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy

  • G8509

    Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given

  • G8510

    Screening for depression is documented as negative, a follow-up plan is not required

  • G8511

    Screening for depression documented as positive, follow-up plan not documented, reason not given

  • G8530

    Autogenous av fistula received

  • G8531

    Clinician documented that patient was not an eligible candidate for autogenous av fistula