G0176 HCPCS code: Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)
G0176 is the HCPCS Level II code for activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more). Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 5 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Y2 |
| Added | 2001-01-01 |
| Last action effective | 2024-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 5 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A56685: Billing and Coding: Partial Hospitalization Programs (Palmetto GBA (MAC - Part A))
- A56850: Billing and Coding: Psychiatric Partial Hospitalization Programs (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A57053: Billing and Coding: Psychiatric Partial Hospitalization Programs (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
Covered diagnoses (515 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| F06.0 | Psychotic disorder with hallucinations due to known physiological condition | 3 |
| F06.2 | Psychotic disorder with delusions due to known physiological condition | 3 |
| F06.31 | Mood disorder due to known physiological condition with depressive features | 3 |
| F06.32 | Mood disorder due to known physiological condition with major depressive-like episode | 3 |
| F06.33 | Mood disorder due to known physiological condition with manic features | 3 |
| F06.34 | Mood disorder due to known physiological condition with mixed features | 3 |
| F06.4 | Anxiety disorder due to known physiological condition | 3 |
| F10.14 | Alcohol abuse with alcohol-induced mood disorder | 3 |
| F10.151 | Alcohol abuse with alcohol-induced psychotic disorder with hallucinations | 3 |
| F10.180 | Alcohol abuse with alcohol-induced anxiety disorder | 3 |
Showing 10 of 515. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for G0176
- 2001-01-01: G0176 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 G0176?
G0176 is the HCPCS Level II code for activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more). Short descriptor: "Opps/php/iop; activity thrpy".
Does Medicare cover G0176?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for G0176?
Medicare policy articles that cite G0176 list 515 covered ICD-10-CM diagnosis codes across 3 articles. The most cited include F06.0 (Psychotic disorder with hallucinations due to known physiological condition), F06.2 (Psychotic disorder with delusions due to known physiological condition), F06.31 (Mood disorder due to known physiological condition with depressive features). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of G0176 can be billed per day?
5 on outpatient hospital claims (NCCI medically unlikely edits).
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 G0176
- Watch G0176 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0176
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.