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See a sample rate comparisonHCPCS G0159 Fee Schedule
HCPCS G0159 is classified under Procedures / Professional Services, in the Miscellaneous Diagnostic and Therapeutic Services subgroup.
Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Miscellaneous Diagnostic and Therapeutic Services |
| Complexity Level | Low |
National average reimbursement for HCPCS G0159 by major payers:
$22.24
BCBS / Anthem
$40.02
UnitedHealthcare
$30.44
Aetna
$128.91
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0159.
HCPCS G0159
5 of 12 sample ratesHigher to lower in this preview
Brownstone Physical Therapy, P.C.
$16.00Published rateBrownstone Physical Therapy, P.C.
$16.00Published rateBuffalo Rehab Group Physical Therapy And Occupational Therapy PC
Buffalo Rehab Group
$16.00Published rateBrownstone Physical Therapy, P.C.
$16.00Published rateBuffalo Rehab Group Physical Therapy And Occupational Therapy PC
Buffalo Rehab Group
$16.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0159 vs. Other Miscellaneous Diagnostic and Therapeutic Services Codes
The table lists codes related to G0159. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G0158-HCPCS | Low | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes |
| G0159-HCPCS | Low | Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes |
| G0160-HCPCS | Low | 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0159. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0159 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
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