HCPCS G0151: home health and hospice physical therapist visit
G0151 is the HCPCS code for services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes. Agencies report it under revenue code 042x, one line per visit, and it is the code Medicare checks when another provider bills therapy for a home health patient.
Written by Salman Saeed, CEO and Co-Founder · Reviewed by a Certified Medical Coder · Last reviewed October 2026In short: G0151 reports a physical therapist's visit time, one unit per 15 minutes, on a home health or hospice claim under revenue code 042x. A physical therapist assistant uses G0157 instead. While a home health period is open, Medicare can deny outside therapy claims for the same patient under consolidated billing.
What does HCPCS G0151 report?
G0151 is a HCPCS Level II code. The CMS code file reads "Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes." It counts the time of a therapist's visit, not a treatment technique.
| Item | Value in the CMS files |
|---|---|
| Short label CMS uses | Hhcp-serv of pt,ea 15 min |
| Added to the HCPCS file | July 1, 1999 (last action effective January 1, 2011) |
| Termination date | None shown in the October 2026 file |
| Medicare coverage code | C, carrier judgment |
| HCPCS processing note 0082 | G0151 to G0156 may be billed only for home health care services provided under a plan of care |
| Physician fee schedule status (RVU26D) | X, statutory exclusion, no RVUs |
| Practitioner MUE table, effective October 1, 2026 | No row for G0151 |
Which physical therapy code goes on the line?
Chapter 10 lists four physical therapy visit codes under revenue code 042x. Who made the visit and what the visit was for decide which one applies.
| Code | Clinician | Service in the chapter 10 list |
|---|---|---|
| G0151 | Physical therapist | Services in the home health or hospice setting |
| G0157 | Physical therapist assistant | Services in the home health or hospice setting |
| G0159 | Physical therapist | Establishing or delivering a maintenance program, home health setting |
| G2168 | Physical therapist assistant | Delivering a maintenance program, home health setting |
Each visit gets one G-code. If the therapist treats the patient and also sets up a maintenance program, chapter 10 says to report the code for the service that took most of the time, with units for the total time of the visit. The modifiers GN, GO and GP, which mark a therapy plan of care, are not required on home health claims.
How does G0151 sit on the claim?
Both claims are UB-04 institutional claims. Revenue code 042x goes in FL 42, G0151 in FL 44, the visit date in FL 45 and the units in FL 46.
| Item | Home health | Hospice |
|---|---|---|
| Bill type | 032x only; a 034x claim with the G-code is returned | Hospice claim with line item dates |
| Lines | One line per visit | Each visit on its own line with date and charge |
| Units | 15-minute increments that made up the visit | Multiplier for the total visit time in the HCPCS description |
| Telehealth | G0320 or G0321 on a separately dated 042x line, 1 unit | Not addressed in chapter 11 |
A practice billing therapy on a professional claim reports its own therapy codes instead, such as 97110 and 97161. See physical therapy billing for that side and home health billing for the agency claim.
How is G0151 paid?
G0151 has no fee schedule price, so it is not paid per visit. A home health agency receives one case-mix amount for the 30-day period of care. A hospice receives its daily rate, and chapter 11 says no additional payment is made on visit revenue lines.
The visit lines still matter. Under section 10.1.17, a period with fewer visits than the threshold is paid per visit, and a first or only period also gets an add-on payment. Medicare puts that add-on on the earliest dated visit line for skilled nursing, physical therapy, occupational therapy or speech-language pathology, so a G0151 line can carry it.
How does consolidated billing affect G0151 and outside therapy claims?
Under home health consolidated billing, only the primary agency bills most services during an open period. Chapter 10, section 20.2 names outpatient therapy among the services most affected, with an exception for therapy a physician provides. On institutional claims of the bill types it lists, Medicare reads every line under 042x, 043x and 044x as therapy.
| What happened | What Medicare does |
|---|---|
| Home health claim was processed first | Outside therapy lines are rejected or denied before payment: CO, CARC 97, RARC N390 |
| Outside claim was paid first | Post-payment denial, with recovery from the provider |
| Only an NOA is on file | Claim is paid with a line-level CO alert, RARC N88, and may be recouped later |
| Professional claim, place of service 12, no NOA yet | Payment notice on the remittance warns of consolidated billing |
X12 defines RARC N390 as "This service/report cannot be billed separately." The denial is shown as provider liability so the outside therapist asks the agency about a payment arrangement. Section 20.1.1 says the patient can be liable only when the agency did not know of the services and the patient was properly notified.
What about hospice patients?
Hospice staff physical therapy goes on 042x with G0151 or G0157 and is paid inside the daily rate. For hospice patients, chapter 11, section 40.2 has contractors deny related claims from independently practicing physical therapists, since these services are included in the hospice rate. That denial is CO-B9. If these denials keep coming back, our denial management team can work them.
Which UB-04 fields carry a PT visit under G0151?
A home health agency lists each visit as its own line. FL 42 holds revenue code 042x, FL 44 holds G0151, FL 45 holds the visit date and FL 46 holds the units, one per 15 minutes. Chapter 25 says a dated line is required for every iteration of every revenue code on the listed outpatient bills, a list that includes type of bill 032X.
RVU26D gives G0151 status X, a statutory exclusion with no RVUs or payment amounts under the physician fee schedule. The practitioner MUE table has no row for it.
Example: A therapist visits on 10/06 for 45 minutes and again on 10/08 for 30 minutes. The claim shows two lines: 10/06 with 3 units and 10/08 with 2 units. One line with 5 units dated 10/06 hides the second visit and breaks the dated-line rule.
Related codes
- HCPCS Level II quarterly update, October 2026 alpha-numeric file · CMS
- Physician Fee Schedule relative value files, RVU26D (October 2026) · CMS
- Medicare NCCI Medically Unlikely Edits, practitioner services table, effective 10-01-2026 · CMS
- Medicare Claims Processing Manual, Chapter 10: Home Health Agency Billing · CMS
- Medicare Claims Processing Manual, Chapter 11: Processing Hospice Claims · CMS
- Medicare Claims Processing Manual, Chapter 25: Completing and Processing the Form CMS-1450 Data Set · CMS
- Claim Adjustment Reason Codes · X12
- Remittance Advice Remark Codes · X12
- Medicare Claims Processing Manual, Chapter 26: Completing and Processing Form CMS-1500 Data Set · CMS
- Medicare Claims Processing Manual, Chapter 25: Completing and Processing the Form CMS-1450 Data Set · CMS
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Common questions
Straight answers from the team that does the work.
Ask a billing lead directly. A 20-minute call, Monday to Friday, 9am to 5pm Eastern.
01How do I bill physical therapy in home health (G0151)?
Report revenue code 042x, G0151, the visit date, units and a charge on one line per visit on a type of bill 032x claim. Units are the 15-minute increments of the visit. Use G0157 when a physical therapist assistant made the visit.
02What is the difference between G0151 and G0157?
G0151 is for a visit by a qualified physical therapist and G0157 is for a visit by a physical therapist assistant. Both are billed in 15-minute units under revenue code 042x, in home health and in hospice, so the code must match who made the visit.
03Do home health therapy claims need modifier GP?
No. Chapter 10 says modifiers GN, GO and GP, which indicate services under a therapy plan of care, are not required on home health claims. The G-code, revenue code 042x, visit date, units and charge identify each visit on the claim.
04Why was an outside therapy claim denied for a home health patient?
Consolidated billing makes the primary home health agency responsible for therapy during an open period. Medicare denies the outside claim with group code CO, CARC 97 and RARC N390. The therapist should ask the agency whether it arranged and will pay for the service.
05Can a hospice report G0151?
Yes. Hospices report visits by their own or contracted physical therapists on revenue code 042x with G0151, or G0157 for an assistant, one line per visit in 15-minute units. Medicare pays nothing extra on those lines because the daily rate covers them.
Therapy lines denied for home health patients?
We check the revenue code, G-code, units and period of care before the claim is sent.