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HCPCS G0152 · Level II · G code

G0152: Hhcp-serv of ot,ea 15 min, 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 G0152

Medicare payment
no PFS amount
PFS status X
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
MUE
none published
no MUE in the 2026 Q4 tables
OPPS status
SI B
Non-allowed item or service for OPPS
NCCI PTP pairs
18
16 hospital outpatient
LCDs and articles
2 / 2

TL;DR

HCPCS Level II G0152 reads "Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes" in the October 2026 file; it dates from 1999. The physician fee schedule lists G0152 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. In the NCCI PTP files v323r0 G0152 appears in 0 practitioner pairs as column 2 and 18 as column 1, and in 1 hospital outpatient pairs as column 2 and 15 as column 1. 2 active LCDs and 2 billing and coding articles list G0152 across 16 states: L34560 (Home Health Occupational Therapy), L34561 (Home Health - Psychiatric Care), A53057, A56756. OPPS status indicator B: Non-allowed item or service for OPPS. HCPCS record: BETOS Y2 (other - non-Medicare fee schedule); pricing indicator 00; type of service 1 (medical care). Nearby codes: G0151, G0153, G0155, G0156.

G0152 descriptor and code status

The October 2026 HCPCS Level II file describes G0152 as “Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G0152 CPT code", G0152 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of G0152
FieldValue
Short descriptorHhcp-serv of ot,ea 15 min
Added to HCPCS1999-07-01
Last actionN (no maintenance), effective 2011-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator00: not separately priced by Part B
BETOS categoryY2: other - non-Medicare fee schedule
Type of service1: medical care

Medicare payment for G0152

The physician fee schedule lists G0152 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 B (Non-allowed item or service for OPPS), with no separate OPPS payment rate.

Medically Unlikely Edits for G0152

CMS publishes no MUE for G0152 in the 2026 Q4 practitioner, facility or DME supplier tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the quantity furnished on every claim.

The MUE lookup for G0152 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0152 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 18 (61% modifier-allowed); 85 earlier pairs have been deleted.

Column-2 codes bundled into G0152 (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, G0152 is the column-2 (bundled) code in 1 active pair, 100% of which allow a modifier and the column-1 code in 15 (73% modifier-allowed); 18 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.

Column-1 codes most often paired with G0152 (hospital outpatient)
Column-1 codePairs
G0177 Opps/php/iop; train & educ1
Column-2 codes bundled into G0152 (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

G0152 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 G0152 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0152

2 active Local Coverage Determinations and 2 billing and coding articles list G0152. 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 G0152
ArticleTitleContractor(s)Related LCD
A53057Billing and Coding: Home Health Occupational TherapyPalmetto GBAL34560
A56756Billing and Coding: Home Health - Psychiatric CarePalmetto GBAL34561

Denials to expect on G0152

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists G0152

CARC 151 · N362

units exceed what the payer considers medically likely for one 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 G0152 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0152 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 G0152

What does HCPCS code G0152 describe?

"Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes" (short descriptor "Hhcp-serv of ot,ea 15 min"), in the G section (procedures and professional services, temporary). Added 1999-07-01; last action N (no maintenance) effective 2011-01-01.

Is G0152 a CPT code?

No. G0152 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "G0152 CPT code" mean this Level II code.

What does Medicare pay for G0152?

The physician fee schedule lists G0152 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it.

Does Medicare cover G0152?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 2 active LCDs and 2 billing and coding articles list G0152 across 16 states: L34560 (Home Health Occupational Therapy), L34561 (Home Health - Psychiatric Care), A53057, A56756.

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.