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CPT codes to report therapist services under Home Health Prospective Payment System (HH PPS)


In order for CMS to collect more specific information regarding the sort of services provided to home health patients, we are
revising the current descriptions for existing G-codes for physical therapists (G0151), occupational therapists (G0152), and speech-language pathologists (G0153), to include in the descriptions that they are intended for the reporting of services provided by a qualified physical or occupational therapist or speech language pathologist.

In addition CMS has added two new G-codes (G0157 and G0158) effective from the dates of services Jan 1, 2011 for the reporting of physical therapy and occupational therapy services provided by qualified therapy assistants.

• G0151 Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes.

• G0152 Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes.

• G0153 Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes.

• G0157 Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes.

• G0158 Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes.

In addition to the above CMS has also added three new G-codes for the reporting of the establishment or delivery of therapy maintenance programs by qualified therapists. The following are descriptions for those new G-codes, for the reporting of the establishment or delivery of therapy maintenance programs by therapists:

• G0159 Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes.

• G0160 Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes.

• G0161 Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes.

Reference: https://www.cms.gov/transmittals/downloads/R824OTN.pdf

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