G0151, G0152, G0153, G0155, G0156, G0157, G0158, G0159, G0160, G0161, cpt codes for Home Health Physical Therapy, Home Health Physical Therapy cpt codes, hcpcs codes for Home Health Physical Therapy, Home Health Physical Therapy hcpcs codes

How To Bill Home Health Physical Therapy (PT) – HCPCS Codes & Guidelines

The HCPCS codes for home health physical therapy are provided below, together with the billing guidelines and official descriptions of the codes. 

1. G0151

Report HCPCS code G0151 for services given by a qualified physical therapist in a home or hospice setting. Report G0151 for every 15 minutes.

1.1 Description

The official description of HCPCS code G0151 is: “Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes.”

1.2 Billing Guidelines

Physical therapy improves a patient’s strength and mobility. Report G0151 for services given by a qualified physical therapist in a home or hospice setting. 

The plan of treatment depends upon the condition of the patient. The time that the physical therapist actively invests in the patient is the reporting time, which is 15 minutes per unit.

The minimum time spent on the service should be eight minutes. Medicare covers the service if the physical therapist submits the necessary documentation.

You should not report G0151 with CPT codes for physiotherapy. These include CPT 97012 until CPT 97036, CPT 97110 until CPT 97124, CPT 97140 until CPT 97546, or CPT 97750.

2. G0152

Report HCPCS code G0152 services provided by qualified occupational therapists. The service is provided in a hospice or a home health setting. This code can be billed for every fifteen minutes.

2.1 Description

HCPCS officially describes G0152 as: “Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes.”

2.2 Billing Guidelines

The ability of a patient to carry out day-to-day activities can be improved with occupational therapy.

HCPCS code G0152 can be reported for services provided by qualified occupational therapists.

You can report G0152 every 15 minutes that the qualified occupational therapist provided services for a minimum of 8 minutes.

If the necessary documentation is provided, Medicare can cover HCPCS code G0152.

Do not report G0152 with the CPT codes for occupational therapy. These include CPT 97150, CPT 97530 until CPT 9735, CPT 97542 until CPT 97545, or CPT 97750.

3. G0153

Report HCPCS code G0153 for services provided by a qualified speech-language pathologist. The services are provided in a hospice or home setting and can be reported in units of 15 minutes.

3.1 Description

HCPCS officially describes G0153 as: “Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes.”

3.2 Billing Guidelines

Speach-language therapy can improve the swallowing and communication skills of a patient with disorders like:

  • cleft palate;
  • stroke; or
  • cerebral palsy.

This code includes the following services:

  • improvement of language skills;
  • strengthening of tongue muscles;
  • how to make sounds; and
  • alternative communication methods.

Medicare can reimburse G0153 if the speech-language pathologist provides the necessary documentation.

4. G0155

Report HCPCS code G0155 in units of 15 minutes for services provided by clinical social workers for a patient in a hospice or home health setting.

4.1 Description

HCPCS code G0155 is officially defined as: “Services of clinical social worker in home health or hospice settings, each 15 minutes.”

4.2 Billing Guidelines

Services provided by clinical social workers improve the maintenance and restoration of functional abilities and a patient’s health.

Possible services are:

  • development for alternative living plans;
  • encouragement of alternative living plans;
  • education about community resources;
  • short-term therapy,
  • lifestyle counseling; and
  • counseling on grief.

Report G0155 in units of 15 minutes with a minimum of 8 minutes. Medicare reimburses this code if the proper documentation is provided.

5. G0156

HCPCS code G0156 can be reported for home health or hospice aide services for a patient in a hospice or home health setting. This code can be billed for every 15 minutes that the service is provided.

5.1 Description

G0156 is officially defined by HCPCS as: “Services of home health/hospice aide in home health or hospice settings, each 15 minutes.”

5.2 Billing Guidelines

The services covered by G0156 aim to promote the maintenance and/or restoration of functional and health abilities for a patient in a hospice or home setting.

These types of services can include:

  • massages;
  • cleaning and care of a urinary catheter;
  • walking assistance;
  • transfer assistance;
  • nail care;
  • position changes for bedridden patients;
  • incontinence care;
  • education about hygiene and nutrition;
  • psychological support; and
  • any services that make the daily activities of a patient easier.

Medicare covers G0156 if all the necessary documentation is submitted. At least 8 minutes need to be spent on this service. Bill this code in units of 15 minutes.

6. G0157

Report HCPCS code G0157 for services provided by an assistant of a qualified physical therapist in a hospice or home health setting. This code can be billed for every 15 minutes that the service is provided.

6.1 Description

The official definition of G0157 is defined by HCPCS and is as follows: “Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes.”

6.2 Billing Guidelines

G0157 can be used for services provided by a physical therapist’s assistant. Report this code for services provided for a homebound patient to promote maintenance and/or restore a patient’s health and functional ability.

Services that are included in HCPCS code G0157 are:

  • reducing physical barriers;
  • relieve the patient of pain; and
  • exercises to improve mobility.

The physical therapist’s assistant can also encourage the patient with the following:

  • gait training;
  • electrical stimulation;
  • massages; and
  • mechanical traction.

The physical therapist’s assistant records the responses of the patients.

7. G0158

Report HCPCS code G0158 when a qualified occupational therapist assistant performed hospice or home health services for a patient. Bill this code in units of 15 minutes.

7.1 Description

G0158 is an HCPCS code and is officially described as: “Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes.”

7.2 Billing Guidelines

G0158 can be billed when a qualified occupational therapist assistant provides services for a homebound patient with the aim of promoting maintenance and restoration of the patient’s functional abilities and health.

These services include helping the patient;

  • become independent in daily living activities;
  • with psychological disorders;
  • with emotional limitations;
  • overcome physical limitations;
  • transfers from bed to wheelchair (or the other way around).

Report G0158 for every 15 minutes, a qualified occupational therapy assistant invested time in the patient with a minimum of 8 minutes.

If proper documentation is provided, Medicare or other payers may cover HCPCS code G0158.

8. G0159

Report HCPCS code G0159 for home health services provided by a qualified physical therapist to deliver or establish an effective and safe physical therapy maintenance program. Bill this code for every 15 minutes of service with a minimum of at least 8 minutes.

8.1 Description

The G0159 code is officially described by HCPCS as: “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.”

8.2 Billing Guidelines

Bill HCPCS G0158 for homebound patients who received services from a qualified physical therapist to promote maintenance and/or restoration of functional and/or health abilities with physical rehabilitation.

An initial evaluation, a therapeutic custom exercise program, regular assessments of the progress of the patient, and, if needed, a reevaluation of the custom exercise plan are included in this code.

Provided all necessary documentation to get G0158 reimbursed by Medicare. Services that take less than 8 minutes can not be billed.

9. G0160

Report HCPCS code G0160 when a qualified occupational therapist provided services for a patient in a home health setting.

The services aim to deliver and establish an effective and safe occupational therapy maintenance program for the patient. Report G0160 in units of 15 minutes.

9.1 Description

HCPCS code G0160 is officially defined as: “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.”

9.2 Billing Guidelines

Bill G0160 for services for homebound patients provided by qualified occupational therapists. These services are meant to help the patient maintain and restore functional abilities and overall health with daily therapeutic activities.

The services include;

  • an initial patient evaluation;
  • a custom program for independence;
  • regular assessments of progress;
  • reevaluations.

A minimum of 8 minutes is required to bill this code. You can only report it in units of 15 minutes.

10. G0161

Report HCPCS code G0161 for services of a speech-language pathologist for a patient receiving home health services to establish or deliver a safe and effective speech-language pathology maintenance program in increments of 15 minutes.

10.1 Description

HCPCS code G0161 is officially described as: “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.”

10.2 Billing Guidelines

A qualified speech-language pathologist provides services for a homebound patient to promote the restoration and maintenance of health and functional ability through improving communication and swallowing skills.

These services include performing an initial evaluation and planning a custom program based on the patient’s needs to improve language skills, strengthen tongue muscles, teach alternative methods of communication, and improve swallowing ability to prevent aspiration.

The speech-language pathologist carries out the program and performs regular assessments of the patient’s progress with reevaluation of the plan as required.

The time that a qualified speech-language pathologist actively invests in the patient is the reporting time, which is 15 minutes a unit.

The minimum time spent on the service should be eight minutes. Medicare covers the service if the speech-language pathologist submits the necessary documentation.

11. References

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

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R859OTN.pdf

https://www.cgsmedicare.com/hhh/claims/hh_billing_codes.html

https://www.bcbsnd.com/providers/policies-precertification/reimbursement-policy/home-health-services

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