New Codes for Therapist Assistants Providing Maintenance Programs in the Home Health Setting

Published 12/11/2020

Change Request (CR) 11721 informs you of the changes to Home Health (HH) billing and processing instructions, including new G-codes that describe therapy assistant services. Make sure that your billing staffs are aware of these changes.

The two new HCPCS G-codes are:
  • 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
On January 4, 2021, RCD providers can begin submitting pre-claim review (PCR) requests with these new HCPCS G-codes. Medicare systems will accept these requests when submitted on or after January 1, 2021 for dates of service on or after January 1, 2020.

For more information, please visit the MLN Matters Article: MM11721 (PDF, 168 KB).

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