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New G-codes for Maintenance Performed in Home Health by Assistants

New G-codes for Maintenance Performed in Home Health by Assistants

On May 1, 2020, CMS released Change Request R10086CP  which outlines billing and claims processing instructions for two new HCPCS G-codes that describe maintenance services provided by a PTA or an OTA in the home health setting. These two new codes are to be implemented October 5, 2020.

      • 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
      • 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

CMS states these new codes will be accepted by Medicare systems when submitted after October 5, 2020, for dates of service on or after January 1, 2020. Until then, home health agencies should continue to report G0157 and G0158 for any services provided by assistants in 2020.

Holly Hester

Holly Hester is Casamba’s Senior Vice President of Compliance & Education, as well as the Compliance Officer. She provides regulatory guidance and interpretation, clinical programming and content development, education and training steerage, and compliance support for the company. As a physical therapist for more than 20 years, Holly has multi-venue clinical and management experience, giving her a unique perspective on the integration of compliance and training with therapy service delivery and clinical practice.
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