G0161 HCPCS code: Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes
G0161 is the HCPCS Level II code for services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology 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
- A53052: Billing and Coding: Home Health Speech-Language Pathology (Palmetto GBA (HHH MAC))
Covered diagnoses (217 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| F01.518 | Vascular dementia, unspecified severity, with other behavioral disturbance | 1 |
| F01.A18 | Vascular dementia, mild, with other behavioral disturbance | 1 |
| F01.B18 | Vascular dementia, moderate, with other behavioral disturbance | 1 |
| F01.C18 | Vascular dementia, severe, with other behavioral disturbance | 1 |
| F02.818 | Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance | 1 |
| F02.A18 | Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance | 1 |
| F02.B18 | Dementia in other diseases classified elsewhere, moderate, with other behavioral disturbance | 1 |
| F02.C18 | Dementia in other diseases classified elsewhere, severe, with other behavioral disturbance | 1 |
| F80.1 | Expressive language disorder | 1 |
| F80.2 | Mixed receptive-expressive language disorder | 1 |
Showing 10 of 217. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for G0161
- 2011-01-01: G0161 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 G0161?
G0161 is the HCPCS Level II code for services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes. Short descriptor: "Hhc slp ea 15 min".
Does Medicare cover G0161?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for G0161?
Medicare policy articles that cite G0161 list 217 covered ICD-10-CM diagnosis codes across 1 article. The most cited include F01.518 (Vascular dementia, unspecified severity, with other behavioral disturbance), F01.A18 (Vascular dementia, mild, with other behavioral disturbance), F01.B18 (Vascular dementia, moderate, 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 G0161
- Watch G0161 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0161
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.