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HCPCS G0153 · Level II · G code

G0153: Hhcp-svs of s/l path,ea 15mn, 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 G0153

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
48
46 hospital outpatient
LCDs and articles
1 / 1

TL;DR

CMS describes HCPCS G0153, added in 1999, as "Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes". The physician fee schedule lists G0153 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 G0153 appears in 1 practitioner pairs as column 2 and 47 as column 1 (most often with 92626), and in 2 hospital outpatient pairs as column 2 and 44 as column 1. 1 active LCD and 1 billing and coding article list G0153 across 16 states: L34563 (Home Health Speech-Language Pathology), A53052. 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: G0152, G0151, G0155, G0156.

G0153 descriptor and code status

The October 2026 HCPCS Level II file describes G0153 as “Services performed by a qualified speech-language pathologist 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 "G0153 CPT code", G0153 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 G0153
FieldValue
Short descriptorHhcp-svs of s/l path,ea 15mn
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 G0153

The physician fee schedule lists G0153 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 G0153

CMS publishes no MUE for G0153 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 G0153 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0153 is the column-2 (bundled) code in 1 active pair, 100% of which allow a modifier and the column-1 code in 47 (87% modifier-allowed); 84 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 G0153 (practitioner)
Column-1 codePairs
92626 (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into G0153 (practitioner)
Column-2 codePairs
0208T (CPT; descriptor licensed by AMA)1
0209T (CPT; descriptor licensed by AMA)1
0210T (CPT; descriptor licensed by AMA)1
0211T (CPT; descriptor licensed by AMA)1
0212T (CPT; descriptor licensed by AMA)1
0485T (CPT; descriptor licensed by AMA)1
0486T (CPT; descriptor licensed by AMA)1
36591 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, G0153 is the column-2 (bundled) code in 2 active pairs, 100% of which allow a modifier and the column-1 code in 44 (93% modifier-allowed); 17 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 G0153 (hospital outpatient)
Column-1 codePairs
92626 (CPT; descriptor licensed by AMA)1
G0177 Opps/php/iop; train & educ1
Column-2 codes bundled into G0153 (hospital outpatient)
Column-2 codePairs
0208T (CPT; descriptor licensed by AMA)1
0209T (CPT; descriptor licensed by AMA)1
0210T (CPT; descriptor licensed by AMA)1
0211T (CPT; descriptor licensed by AMA)1
0212T (CPT; descriptor licensed by AMA)1
0485T (CPT; descriptor licensed by AMA)1
0486T (CPT; descriptor licensed by AMA)1
92507 (CPT; descriptor licensed by AMA)1

G0153 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 G0153 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0153

1 active Local Coverage Determination and 1 billing and coding article list G0153. 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 G0153
ArticleTitleContractor(s)Related LCD
A53052Billing and Coding: Home Health Speech-Language PathologyPalmetto GBAL34563

Denials to expect on G0153

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists G0153

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 G0153 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0153 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 G0153

What does HCPCS code G0153 describe?

"Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes" (short descriptor "Hhcp-svs of s/l path,ea 15mn"), in the G section (procedures and professional services, temporary). Added 1999-07-01; last action N (no maintenance) effective 2011-01-01.

Is G0153 a CPT code?

No: CMS maintains G0153 in HCPCS Level II, while the AMA maintains CPT. People do search "G0153 CPT code", and it goes in the same procedure-code field.

What does Medicare pay for G0153?

The physician fee schedule lists G0153 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 G0153?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD and 1 billing and coding article list G0153 across 16 states: L34563 (Home Health Speech-Language Pathology), A53052.

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.