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HCPCS G0129 · Level II · G code

G0129: Occupational therapy services requiring the skills of a qualified occupational therapist, HCPCS Level II G code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for G0129

Medicare payment
no PFS amount
PFS status X
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Facility outpatient MUE
6
MAI 3
OPPS status
SI P
Partial Hospitalization or Intensive Outpatient Program
NCCI PTP pairs
19
16 hospital outpatient
LCDs and articles
3 / 3

TL;DR

CMS describes HCPCS G0129, added in 2000, as "Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization or intensive outpatient treatment program, per session (45 minutes or more)". The physician fee schedule lists G0129 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. MUE limits for G0129: hospital outpatient 6 (MAI 3, Clinical: CMS Workgroup). In the NCCI PTP files v323r0 G0129 appears in 0 practitioner pairs as column 2 and 19 as column 1, and in 0 hospital outpatient pairs as column 2 and 16 as column 1. 3 active LCDs and 3 billing and coding articles list G0129 across 14 states: L33626 (Psychiatric Partial Hospitalization Programs), L37633 (Partial Hospitalization Programs), A56685, A56850. OPPS status indicator P: Partial Hospitalization or Intensive Outpatient Program. HCPCS record: BETOS Y1 (other - Medicare fee schedule); pricing indicator 00; type of service U (occupational therapy). Nearby codes: G0130, G0127, G0124, G0123.

G0129 descriptor and code status

The October 2026 HCPCS Level II file describes G0129 as “Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization or intensive outpatient treatment program, per session (45 minutes or more)”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.

HCPCS file attributes of G0129
FieldValue
Short descriptorPhp/iop ot service
Added to HCPCS2000-04-01
Last actionN (no maintenance), effective 2024-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator00: not separately priced by Part B
BETOS categoryY1: other - Medicare fee schedule
Type of serviceU: occupational therapy

Medicare payment for G0129

The physician fee schedule lists G0129 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator P (Partial Hospitalization or Intensive Outpatient Program), with no separate OPPS payment rate.

Medically Unlikely Edits for G0129

MUE limits for G0129: hospital outpatient 6 (MAI 3, Clinical: CMS Workgroup). The facility outpatient MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for G0129 by setting
SettingMUE (units/DOS)MAICMS rationale
Facility outpatient hospital63 Date of Service Edit: ClinicalClinical: CMS Workgroup

The MUE lookup for G0129 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0129 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 19 (63% modifier-allowed); 83 earlier pairs have been deleted.

Column-2 codes bundled into G0129 (practitioner)
Column-2 codePairs
36591 (CPT; descriptor licensed by AMA)1
36592 (CPT; descriptor licensed by AMA)1
96523 (CPT; descriptor licensed by AMA)1
97150 (CPT; descriptor licensed by AMA)1
97161 (CPT; descriptor licensed by AMA)1
97162 (CPT; descriptor licensed by AMA)1
97163 (CPT; descriptor licensed by AMA)1
97164 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, G0129 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 16 (75% modifier-allowed); 17 earlier pairs have been deleted.

Column-2 codes bundled into G0129 (hospital outpatient)
Column-2 codePairs
97150 (CPT; descriptor licensed by AMA)1
97161 (CPT; descriptor licensed by AMA)1
97162 (CPT; descriptor licensed by AMA)1
97163 (CPT; descriptor licensed by AMA)1
97164 (CPT; descriptor licensed by AMA)1
97165 (CPT; descriptor licensed by AMA)1
97166 (CPT; descriptor licensed by AMA)1
97167 (CPT; descriptor licensed by AMA)1

G0129 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check G0129 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0129

3 active Local Coverage Determinations and 3 billing and coding articles list G0129. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing G0129
ArticleTitleContractor(s)Related LCD
A56685Billing and Coding: Partial Hospitalization ProgramsPalmetto GBAL37633
A56850Billing and Coding: Psychiatric Partial Hospitalization ProgramsWellpoint FederalL33626
A57053Billing and Coding: Psychiatric Partial Hospitalization ProgramsCGS Administrators, LLCL34196

Denials to expect on G0129

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists G0129

CARC 151 · N362

units of G0129 exceed the facility outpatient MUE of 6 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for G0129 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0129 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS G0129

What does HCPCS code G0129 describe?

"Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization or intensive outpatient treatment program, per session (45 minutes or more)" (short descriptor "Php/iop ot service"), in the G section (procedures and professional services, temporary). Added 2000-04-01; last action N (no maintenance) effective 2024-01-01.

Is G0129 a CPT code?

No: CMS maintains G0129 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.

What does Medicare pay for G0129?

The physician fee schedule lists G0129 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it.

How many units of G0129 can be billed per day?

MUE limits for G0129: hospital outpatient 6 (MAI 3, Clinical: CMS Workgroup). For the facility outpatient MUE (MAI 3), units above 6 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover G0129?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 3 active LCDs and 3 billing and coding articles list G0129 across 14 states: L33626 (Psychiatric Partial Hospitalization Programs), L37633 (Partial Hospitalization Programs), A56685, A56850.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.