HCPCS code G0176 — Opps/php/iop; activity thrpy.
Status: Active.
Effective Jan 1, 2024.
Source: CMS HCPCS Level II.
G0176
ActiveOpps/php/iop; activity thrpy
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)
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 2024
Code type:
alphanumeric
OPPS Status:
P
— Partial hospitalization
MUE — Medically Unlikely Edits
Maximum units of G0176 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 5 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits — Reverse Direction
G0176 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0409 | Modifier may bypass edit |
| G0410 | Modifier may bypass edit |
| G0411 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)
Change History
Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.