HCPCS code G9012: Other specified case management service not elsewhere classified

G9012 is specifically for case management delivered by non-clinical staff. In contrast, G9008 applies when clinical staff (e.g., MDs, NPs, RNs, LCSWs) deliver ECM services. Proper differentiation ensures correct billing and reimbursement.

No, documentation of outreach using G9012 + U8 (or with GQ for telehealth) typically does not require a TAR, though the activity must be documented. However, routine ECM services (U2 or U2, GQ) generally do require a TAR.

Yes, G9012 with the appropriate modifier (such as U8) can be used to bill for outreach attempts, regardless of whether the outreach attempt was successful in engaging the member. A separate billing may be allowed for a successful engagement.