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Billing code

G391A — Other resuscitation after first 1/4 hour

Critical care, extra quarter hour

Bill G391 for each extra quarter hour of other critical care after G395, or each quarter hour of life-threatening critical care for later physicians.

Watch for: Record start and stop times in the patient's chart, or it isn't paid; not payable on a per diem day.

Code

G391A

Description

Other resuscitation after first 1/4 hour

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Each extra quarter hour of other critical care after G395, or each quarter hour of life-threatening critical care for the fourth and later physicians.

What it covers

G391 has two uses. Under 'other critical care' (resuscitation where there is a potential threat to life or limb), it is each ¼ hour or part after the first ¼ hour, which is G395, for each of the first three physicians (J28).

Under 'life threatening critical care' (a critical illness or injury causing vital organ system failure), it is the per-¼-hour code for the fourth and each later physician; the first three physicians bill G521, G523 and G522 (J26).

Billing rules

• Time counts only when you are fully devoted to the patient at the bedside, in the ED or on the hospital floor where the patient is, and excludes separately billable procedures; it may be consecutive or not (J26, J28).
• You can't provide services to other patients during the time claimed (J26, J28).
• Start and stop times must be recorded in the patient's permanent medical record, or the service is not payable (J27, J29).
• Not payable to the same physician on a day you are paid a Critical Care, Ventilatory Support, Comprehensive Care or Neonatal Intensive Care per diem (J27, J28).
• The same day, same physician, these are included and not billed separately: assessment and ongoing monitoring, IV lines, cutdowns, arterial or venous catheters, CVP lines, endotracheal intubation, tracheal toilet, blood gases, nasogastric intubation, urinary catheters, pressure infusion sets and drugs, plus defibrillation and cardioversion when G391 is billed as life-threatening critical care (J26, J28).
• Not payable with A384 or K181 (J27); G261, G259 and G115 are not payable with G391 (J12, J13).
• Submit the claim manually when total critical care time is more than 2 hours (J29).
• The E420 trauma premium (add 50%) applies to G391 when rendered on the day of or within 24 hours of the trauma, the Injury Severity Score is over 15 (age 16 or more) or over 12 (under 16), and the ISS is recorded in the medical record (GP109).

Often billed with

• G395 for the first ¼ hour of other critical care by the same physician (J28).
• A003 or another consultation or assessment rendered before or after the critical care, which may be payable separately (J28).
• FHO: Q012A after-hours premium attaches to the listed assessment on the claim, such as A003A, not to G391, which isn't on the §8.12 list (Agreement p.68 §8.12).

Related codes: G395, G521, G523, G522, G211, E420, G557

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Critical Care — Life threatening critical care and Other critical care, pages J26–J29; trauma premium GP109

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