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Official Description

Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes
Short Descr Hhcp-serv of pt,ea 15 min
Coverage Carrier Priced
Pricing Indicator(s) 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
MPI 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Processing Note G0151
BETOS Y2 – Other - non-Medicare fee schedule
TOS Code(s) 1 – Medical care
Added Date 7/1/1999
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x)
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 236 - Home Health Services
GP Services delivered under an outpatient physical therapy plan of care
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GT Via interactive audio and video telecommunication systems
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
KX Requirements specified in the medical policy have been met
Date
Action
Notes
2010-01-01 Changed Code description changed
1999-07-01 Added Code added 7/1/1999
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Description
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Description
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