G9187 Bpci home visit

Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for G9187

Physician Fee Schedule (CY 2026, RVU26D)

Status A: active, paid separately under the PFS if covered. National amounts: non-facility $51.10, facility $51.10 (total RVUs 1.53 / 1.53 × $33.4009 conversion factor; facility NA: rarely or never done in that setting). Work RVU 0.18, practice expense RVU 1.32 non-facility and 1.32 facility, malpractice RVU 0.03. Global period XXX. Qualifying APM participants are paid at a $33.5675 conversion factor.

Payer policies and prior authorization for G9187

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $42.89 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.