New G-Codes for Home Health Therapy Assistants

From CGS:

CMS has issued Change Request 11721 (MM11721), implementing two new G-codes for maintenance services furnished by physical and occupational therapy assistants on or after January 1, 2020.

Please note that claims submitted with the new G-codes will not be accepted by Medicare systems until the October 5, 2020 implementation date. 

CGS has updated the Home Health Medicare Billing Codes Sheet quick resource tool to include two following new G-codes.  In addition, the Home Health HCPCS Codes list, which is accessible from Claim Page 02 – Entering a RAP or Claim and the Submitting a Final Claim under the Home Health Patient-Driven Groupings Model Webpages.

  • G2168: Services performed by a physical therapist assistant in the Home Health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes
    • Short Descriptor: Svs by pt in Home Health

Report G2168 with revenue code 042X on Home Health claims (type of bill 032x other than 0322).

  • G2169: Services performed by an occupational therapist assistant in the Home Health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes
    • Short Descriptor: Svs by ot in Home Health

Report G2169 with revenue code 043X on Home Health claims (type of bill 032x other than 0322).

Please share this information with your therapist and billing staff.

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