Therapy Non-Payable HCPCS Codes

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Effective for dates of service on/after January 1, 2019, HCPCS G-codes and severity modifiers for functional reporting are no longer required on claims for therapy services.

On this webpage, view the Therapy Non-payable HCPCS code sets.

Physical and Occupational Therapy

Speech Language Pathology

Severity/Complexity Modifiers

Mobility G-code Set

Code Long Descriptor Short Descriptor
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals Mobility current status
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Mobility goal status
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting Mobility D/C status

 

Changing & Maintaining Body Position

Code Long Descriptor Short Descriptor
G8981 Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals. Body pos current status
G8982 Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals and at discharge or to end reporting Body pos goal status
G8983 Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting Body pos D/C status

 

Carrying, Moving & Handling Objects G-code Set

Code Long Descriptor Short Descriptor
G8984 Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals Carry current status
G8985 Carrying, moving & handling objects functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Carry goal status
G8986 Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting Carry D/C status

 

Self Care G-code Set

Code Long Descriptor Short Descriptor
G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals Self care current status
G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Self care goal status
G8989 Self care functional limitation, discharge status, at discharge from therapy or to end reporting Self care D/C status

 

Other PT/OT Primary G-code Set

Code Long Descriptor Short Descriptor
G8990 Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals Other PT/OT current status
G8991 Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Other PT/OT goals status
G8992 Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting Other PT/OT D/C status

 

Other PT/OT Subsequent G-code Set

Code Long Descriptor Short Descriptor
G8993 Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals Sub PT/OT current status
G8994 Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Sub PT/OT current status
G8995 Other physical or occupational therapy subsequent functional limitation, at discharge from therapy or to end reporting. Sub PT/OT D/C status

 

Swallowing G-code Set

Code Long Descriptor Short Descriptor
G8996 Swallowing functional limitation, current status, at therapy episode outset and at reporting intervals Swallow current status
G8997 Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Swallow goal status
G8998 Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting Swallow D/C status

 

Motor Speech G-code Set

(Note: These codes are not sequentially numbered)

Code Long Descriptor Short Descriptor
G8999 Motor speech functional limitation, current status, at therapy episode outset and at reporting intervals Motor speech current status
G9186 Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting Motor speech goal status
G9158 Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting Motor speech D/C status

 

Spoken Language Comprehension G-code Set

Code Long Descriptor Short Descriptor
G9159 Spoken language comprehension functional limitation, current status, at therapy episode outset and at reporting intervals Lang comp current status
G9160 Spoken language comprehension functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Lang comp goal status
G9161 Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting Lang comp D/C status

 

Spoken Language Expressive G-code Set

Code Long Descriptor Short Descriptor
G9162 Spoken language expression functional limitation, current status, at therapy episode outset and at reporting intervals

Lang express current status

G9163 Spoken language expression functional limitation, current status, at therapy episode outset and at reporting intervals

Lang express goal status

G9164 Spoken language expression functional limitation, discharge status, at discharge from therapy or to end reporting

Lang express D/C status

 

Attention G-code Set

Code Long Descriptor Short Descriptor
G9165 Attention functional limitation, current status, at therapy episode outset and at reporting intervals

Atten current status

G9166 Attention functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or end reporting

Atten goal status

G9167 Attention functional limitation, discharge status, at discharge from therapy or to end reporting

Atten D/C status

 

Memory G-code Set

Code Long Descriptor Short Descriptor
G9168 Memory functional limitation, current status, at therapy episode outset and at reporting intervals Memory current status
G9169 Memory functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Memory goal status
G9170 Memory functional limitation, discharge status, at discharge from therapy or to end reporting Memory D/C status

 

Voice G-code Set

Code Long Descriptor Short Descriptor
G9171 Voice functional limitation, current status, at therapy episode outset and at reporting intervals Voice current status
G9172 Voice functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Voice goal status
G9173 Voice functional limitation, discharge status, at discharge from therapy or to end reporting Voice D/C status

 

Other Speech Language Pathology G-code Set

Code Long Descriptor Short Descriptor
G9174 Other speech language pathology functional limitation, current status, at therapy episode outset and at reporting intervals Speech lang current status
G9175 Other speech language pathology functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting Speech lang goal status
G9176 Other speech language pathology functional limitation, discharge status, at discharge from therapy or to end reporting Speech lang D/C status

 

Severity/Complexity Modifiers

Modifier Impairment Limitation Restriction
CH 0 percent (%) impaired, limited or restricted
CI At least 1% but less than 20% impaired, limited or restricted
CJ At least 20% but less than 40% impaired, limited or restricted
CK At least 40% but less than 60% impaired, limited or restricted
CL At least 60% but less than 80% impaired, limited or restricted
CM At least 80% but less than 100% impaired, limited or restricted
CN 100% impaired, limited or restricted

 

Resource

 

Last Updated Wed, 11 Nov 2020 14:31:01 +0000