G0155 HCPCS code: Services of clinical social worker in home health or hospice settings, each 15 minutes
G0155 is the HCPCS Level II code for services of clinical social worker in home health or hospice settings, each 15 minutes. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Y2 |
| Added | 1999-07-01 |
| Last action effective | 2010-01-01 |
Medicare policy articles for this code
- A56756: Billing and Coding: Home Health - Psychiatric Care (Palmetto GBA (HHH MAC))
Covered diagnoses (595 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| F03.90 | Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety | 1 |
| F03.911 | Unspecified dementia, unspecified severity, with agitation | 1 |
| F03.918 | Unspecified dementia, unspecified severity, with other behavioral disturbance | 1 |
| F03.92 | Unspecified dementia, unspecified severity, with psychotic disturbance | 1 |
| F03.93 | Unspecified dementia, unspecified severity, with mood disturbance | 1 |
| F03.94 | Unspecified dementia, unspecified severity, with anxiety | 1 |
| F03.A0 | Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety | 1 |
| F03.A11 | Unspecified dementia, mild, with agitation | 1 |
| F03.A18 | Unspecified dementia, mild, with other behavioral disturbance | 1 |
| F03.A2 | Unspecified dementia, mild, with psychotic disturbance | 1 |
Showing 10 of 595. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for G0155
- 1999-07-01: G0155 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G0155?
G0155 is the HCPCS Level II code for services of clinical social worker in home health or hospice settings, each 15 minutes. Short descriptor: "Hhcp-svs of csw,ea 15 min".
Does Medicare cover G0155?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for G0155?
Medicare policy articles that cite G0155 list 595 covered ICD-10-CM diagnosis codes across 1 article. The most cited include F03.90 (Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety), F03.911 (Unspecified dementia, unspecified severity, with agitation), F03.918 (Unspecified dementia, unspecified severity, with other behavioral disturbance). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Related G01 codes
- G0101 — Cervical or vaginal cancer screening; pelvic and clinical breast examination
- G0102 — Prostate cancer screening; digital rectal examination
- G0103 — Prostate cancer screening; prostate specific antigen test (PSA)
- G0104 — Colorectal cancer screening; flexible sigmoidoscopy
- G0105 — Colorectal cancer screening; colonoscopy on individual at high risk
- G0106 — Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema
- G0108 — Diabetes outpatient self-management training services, individual, per 30 minutes
- G0109 — Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
- G0117 — Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
- G0118 — Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist
- G0120 — Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
- G0121 — Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under G0155
- Watch G0155 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0155
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.