G0160 HCPCS code: Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes
G0160 is the HCPCS Level II code for services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, 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 | 2011-01-01 |
| Last action effective | 2011-01-01 |
Medicare policy articles for this code
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC))
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC))
Covered diagnoses (7,834 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| A18.01 | Tuberculosis of spine | 1 |
| A18.02 | Tuberculous arthritis of other joints | 1 |
| A52.16 | Charcot's arthropathy (tabetic) | 1 |
| B91 | Sequelae of poliomyelitis | 1 |
| E08.40 | Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified | 1 |
| E08.42 | Diabetes mellitus due to underlying condition with diabetic polyneuropathy | 1 |
| E08.44 | Diabetes mellitus due to underlying condition with diabetic amyotrophy | 1 |
| E08.52 | Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene | 1 |
| E08.610 | Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy | 1 |
| E08.618 | Diabetes mellitus due to underlying condition with other diabetic arthropathy | 1 |
Showing 10 of 7,834. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for G0160
- 2011-01-01: G0160 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 G0160?
G0160 is the HCPCS Level II code for services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes. Short descriptor: "Hhc occup therapy ea 15".
Does Medicare cover G0160?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for G0160?
Medicare policy articles that cite G0160 list 7,834 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include A18.01 (Tuberculosis of spine), A18.02 (Tuberculous arthritis of other joints), A52.16 (Charcot's arthropathy (tabetic)). 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 G0160
- Watch G0160 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0160
Sources: CMS HCPCS Level II release October 2025; 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.