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February 27, 2017 - Updated 04.03.19

Valid/Invalid G-Codes for Home Health and Hospice

CGS has seen providers continuing to submit G-codes that are not valid for the dates of services being billed.  Please review the following list of valid and invalid codes with your billing staff to ensure the appropriate code is submitted.  The validity of the HCPCS codes is based on the date services were provided. 

Home Health Invalid HCPCS Codes

HCPCS Code

Invalid For Dates of Service

Description

G0154

Services provided on or after January 1, 2016

Direct skilled services of a licensed nurse (LPN or RN) in the home health or hospice setting, each 15 minutes.

G0162

Services provided on or after January 1, 2017

Skilled services of a licensed nurse (RN only) for management and evaluation of the plan of care, each 15 minutes.

G0163

Services provided on or after January 1, 2017

Skilled services of a licensed nurse (LPN or RN) for the observation and assessment of the patient's condition, each 15 minutes.

G0164

Services provided on or after January 1, 2017

Skilled services of a licensed nurse (LPN or RN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes.

Home Health Valid HCPCS Codes

HCPCS Code

Valid For Dates of Service

Description

G0299

Services provided on or after January 1, 2016

Direct skilled nursing services of a registered nurse (RN) in home health or hospice setting, each 15 minutes.

G0300

Services provided on or after January 1, 2016

Direct skilled nursing of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes. 

G0493

Services provided on or after January 1, 2017

Skilled services of a registered nurse (RN) for the observation and assessment of the patient's condition, each 15 minutes.

NOTE: Only valid for home health providers.

G0494

Services provided on or after January 1, 2017

Skilled services of a licensed practical nurse (LPN) for the observation and assessment of a patient's condition, each 15 minutes.

NOTE: Only valid for home health providers.

G0495

Services provided on or after January 1, 2017

Skilled services of a registered nurse (RN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes. 

NOTE: Only valid for home health providers.

G0496

Services provided on or after January 1, 2017

Skilled services of a licensed practical nurse (LPN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes.

NOTE: Only valid for home health providers.

For home health episodes that span 2015/2016 or 2016/2017, report the appropriate G-code on the detail line based on the date of service. 

Hospice Invalid HCPCS Codes

HCPCS Code

Invalid For Dates of Service

Description

G0154

Services provided on or after January 1, 2016

Direct skilled services of a licensed nurse (LPN or RN) in the home health or hospice setting, each 15 minutes.

Hospice Valid HCPCS Codes

HCPCS Code

Valid For Dates of Service

Description

G0299

Services provided on or after January 1, 2016

Direct skilled nursing services of a registered nurse (RN) in home health or hospice setting, each 15 minutes.

G0300

Services provided on or after January 1, 2016

Direct skilled nursing of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes. 

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