HCPCS Code G0152: Services Performed by a Qualified Occupational Therapist in the Home Health or Hospice Setting, Each 15 Minutes

Learn about the HCPCS Code G0152 for services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes.

Use Code

## **What is HCPCS Code G0152 for?** Code G0152 is one of several revenue codes and home health billing codes for billing (Medicaid) services performed by specific kinds of healthcare professionals and groups (qualified home health providers/home health agency services, registered nurses/direct skilled nursing services, qualified speech-language pathologists, medical social services, home health agencies, qualified physical therapist assistants, qualified occupational therapist assistants, licensed practical nurses, clinical social workers, etc.) who provide home health services. G0152 refers to tailor-fitted services performed and provided by a qualified occupational therapist in the hospice or home health setting, each 15 minutes (meaning the session is only 15 minutes). If you're looking to provide home healthcare services that include occupational therapy, and you're looking for an HCPCS code to use, this is definitely one of them. This code is often used for services that are provided to patients who are dealing with the following problems: They feel pain and have difficulty performing activities of daily living as a result of illness or injury - If they've had a stroke - If they have a chronic or terminal illness - If they're recovering from surgery - If they're currently taking rehabilitation to restore mobility The services provided are designed to help patients regain or improve their independence in activities of daily living, allowing them to rely less on home health aide services (such as caregivers and skilled nursing personnel) and family members for assistance. Qualified occupational therapists typically begin by assessing the patient's current abilities and level of functioning. Then, they will discuss the goals of the OT service and create a customized OT plan based on the patient's needs and capabilities. This plan will likely have exercises and activities for improving the patient's functional status and capabilities. It'll include any tools the OT may deem necessary. During some exercises, the OT may assist the patient, or family members may assist, so they know what they can do when the OT isn't around to provide therapeutic services.

## **Documentation requirements for G0152** As with any service provided, the service provider needs to document everything accordingly. For G0152, the occupational therapist who conducted the session must document the following: - The occupational therapist's full name and credentials - The patient's full name - The patient's medical history - The patient's current and prior functional status - The date of service - Start and stop times of the session - Total minutes of the session - The specific services provided during the session (e.g., functional mobility training, self-care training, cognitive training, etc), including what tools were used, if any. - Assistance from family members and/or caregivers should also be indicated (including their full names) - Patient's response to the services provided - Goals (e.g., improved independence, improved physical function, improved mobility, improved coordination, reduced pain, etc.) - Patient's response toward established goals - Any updates to treatment plans (if there have been established plans before the session)

## **Billing requirements for G0152** In addition to the documentation requirements above, billing requirements include the following coding guidelines and ensuring that sessions are no longer than 15 minutes. This does not include non-skilled time (observation and preparation). Only the time spent providing the actual skilled services is counted. If the services you performed are part of a therapy plan of care, make sure to use the modifier **GO**, which is for services delivered under an outpatient occupational therapy plan of care. If, for whatever reason, your billing goes beyond the threshold amount for occupational therapeutic services, use the modifier **KX**. However, you must justify the medical necessity of going over the threshold; otherwise, your billing request will be rejected.

## **Other similar codes** - **G0151** – Physical therapy in home health/hospice, per 15 minutes - **G0153** – Speech-language pathology in home health/hospice, per 15 minutes - **G0157** – Physical therapist assistant in home health/hospice, per 15 minutes

Frequently asked questions

Not necessarily. They can receive the usual care they get from family members or caregivers, but they can also practice certain exercises and techniques that the OT taught them to continue progress in between visits.

Fatigue and soreness. The worst they can suffer are strains and injuries, but highly-trained OTs will ensure that doesn't happen by adjusting exercises and activities based on how the patient is feeling.

That depends on the cause and the damage done to their independence and functioning. Some patients regain both completely. While others only restore them to a certain level and still require assistance here and there.