CMS Releases Quarterly Update to HCPCS Level II Code Set

by | Last updated May 17, 2023 | Published on Jan 15, 2011 | Medical Coding

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The CMS (Centers for Medicare & Medicaid Services) released quarterly updates to the HCPCS Level II (Healthcare Common Procedure Coding System Level II) code set for medical billing and medical coding. Included in the update are two new codes for tobacco cessation and drug screening and two revised codes for rapid antibody testing for infectious antigens and drug screening.

The changes are effective from January 1, 2011.

Details of the update are given in the table below. The HCPCS code is given first with the status in brackets and the long description after the dash:

    • G0151 (active) – A qualified physical therapist’s services in the hospice or home health setting, each of a duration of 15 minutes
    • G0152 (active) – A qualified occupational therapist’s services in the hospice or home health setting, each of a duration of 15 minutes
    • G0153 (active) – A qualified speech language pathologist’s services in the hospice or home health setting, each of a duration of 15 minutes
    • G0154 (active) – The direct skilled nursing services of a registered nurse or licensed practical nurse in the hospice or home health setting, each of a duration of 15 minutes
  • G0157 (active) – Services rendered by a qualified physical therapist assistant in the hospice or home health setting, each of a duration of 15 minutes
    • G0158 (active) – Services rendered by a qualified occupational therapist assistant in the hospice or home health setting, each of a duration of 15 minutes
  • G0159 (active) – A qualified physical therapist’s services provided in the home health environment in the delivery or establishment of an effective and safe physical therapy maintenance program, each of a duration of 15 minutes
  • G0160 (active) – A qualified occupational therapist’s services provided in the home health environment in the delivery or establishment of an effective and safe occupational therapy maintenance program, each of a duration of 15 minutes
  • G0161 (active) – A qualified speech language pathologist’s services provided in the home health environment in the delivery or establishment of an effective and safe speech-language therapy maintenance program, each of a duration of 15 minutes
  • G0162 (active) – An RN’s (registered nurse’s) skilled services for the evaluation and management of the plan of care, each of a duration of 15 minutes (There is a need for an RN for a patient’s underlying complication or condition to ensure that the required non-skilled care is successful in its resolve in the hospice or home health setting
  • G0163 (active) – Skilled services of a registered nurse or licensed practical nurse for the observation and evaluation of the patient’s condition, each of a duration of 15 minutes. (If there is any change in the patient’s condition, it needs skilled nursing personnel to recognize and assess the patient’s need for potential change of treatment in the hospice or home health setting)
  • G0164 (active) – The skilled services of a registered nurse or licensed physical nurse in the education or training of a family member or patient, in the hospice or home health environment, each of a duration of 15 minutes
  • G0431 (revised) – Drug Screen single class, high complexity test, (e.g. immunoassay, enzyme assay), each specimen
  • G0434 (active) – Drug screen apart from chromatographic; any quantity of drug classes, by moderate complexity test or CLIA waived test, per patient encounter
  • G0435 (revised) – Detection of infectious agent antigen by rapid antibody test of oral mucosa transudate, screening, HIV-1 or HIV-2
  • G0436 (new) – Counseling visit for tobacco and smoking cessation for the asymptomatic patient, up to 10 minutes, more than 3 minutes, or intermediate

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

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