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HCPCS G0176 · Level II · G code

G0176: Activity therapy, such as music, dance, art or play therapies not for recreation, 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 G0176

Medicare payment
no PFS amount
PFS status X
Coverage code
D
special coverage instructions apply
Facility outpatient MUE
5
MAI 3
OPPS status
SI P
Partial Hospitalization or Intensive Outpatient Program
NCCI PTP pairs
20
1 hospital outpatient
LCDs and articles
3 / 3

TL;DR

G0176 is a Level II code from the G section (procedures and professional services, temporary), in use since 2001: "Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)". The physician fee schedule lists G0176 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its 2026 Q4 MUEs per date of service: hospital outpatient 5 (MAI 3, Code Descriptor / CPT Instruction). In the NCCI PTP files v323r0 G0176 appears in 17 practitioner pairs as column 2 and 3 as column 1 (most often with 90832, 90833, 90834), and in 1 hospital outpatient pairs as column 2 and 0 as column 1. 3 active LCDs and 3 billing and coding articles list G0176 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 Y2 (other - non-Medicare fee schedule); pricing indicator 00; type of service U (occupational therapy). Nearby codes: G0175, G0177, G0179, G0180.

G0176 descriptor and code status

The October 2026 HCPCS Level II file describes G0176 as “Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G0176 CPT code", G0176 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 G0176
FieldValue
Short descriptorOpps/php/iop; activity thrpy
Added to HCPCS2001-01-01
Last actionN (no maintenance), effective 2024-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator00: not separately priced by Part B
BETOS categoryY2: other - non-Medicare fee schedule
Type of serviceU: occupational therapy

Medicare payment for G0176

The physician fee schedule lists G0176 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 G0176

Its 2026 Q4 MUEs per date of service: hospital outpatient 5 (MAI 3, Code Descriptor / CPT Instruction). 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 G0176 by setting
SettingMUE (units/DOS)MAICMS rationale
Facility outpatient hospital53 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction

The MUE lookup for G0176 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0176 is the column-2 (bundled) code in 17 active pairs, 100% of which allow a modifier and the column-1 code in 3 (0% modifier-allowed); 37 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 G0176 (practitioner)
Column-1 codePairs
90832 (CPT; descriptor licensed by AMA)1
90833 (CPT; descriptor licensed by AMA)1
90834 (CPT; descriptor licensed by AMA)1
90836 (CPT; descriptor licensed by AMA)1
90837 (CPT; descriptor licensed by AMA)1
90838 (CPT; descriptor licensed by AMA)1
90839 (CPT; descriptor licensed by AMA)1
90840 (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into G0176 (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

In the hospital outpatient PTP file v323r0, G0176 is the column-2 (bundled) code in 1 active pair, 100% of which allow a modifier and the column-1 code in 0; 12 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.

Column-1 codes most often paired with G0176 (hospital outpatient)
Column-1 codePairs
G0409 Corf related serv 15 mins ea1

G0176 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 G0176 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0176

3 active Local Coverage Determinations and 3 billing and coding articles list G0176. 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 G0176
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 G0176

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists G0176

CARC 151 · N362

units of G0176 exceed the facility outpatient MUE of 5 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 G0176 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0176 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 G0176

What does HCPCS code G0176 describe?

"Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)" (short descriptor "Opps/php/iop; activity thrpy"), in the G section (procedures and professional services, temporary). Added 2001-01-01; last action N (no maintenance) effective 2024-01-01.

Is G0176 a CPT code?

No. G0176 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "G0176 CPT code" mean this Level II code.

What does Medicare pay for G0176?

The physician fee schedule lists G0176 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 G0176 can be billed per day?

Its 2026 Q4 MUEs per date of service: hospital outpatient 5 (MAI 3, Code Descriptor / CPT Instruction). For the facility outpatient MUE (MAI 3), units above 5 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover G0176?

Coverage code D (special coverage instructions apply). 3 active LCDs and 3 billing and coding articles list G0176 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.