Eli's Rehab Report

Question: Someone recently pointed out to me HCPCS code G0129 (Occupational therapy requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per day). We report specific CPT codes such as 97003 (Occupational therapy evaluation) or 97537 (Community/work reintegration training ...), so when would G0129 be reportable? I noticed that this code mentions hospital treatment pro-grams, so I want to make sure we, as a hospital outpatient rehab facility, aren't missing out on a more accurate way of reporting OT.

Pennsylvania Subscriber

Answer: Your best bet would be to steer away from the G code and to go with something more specific. Why: The vast majority of Medicare contractors and other non-Medicare insurance payers do not recognize G0129.

Code 97003 (Occupational therapy evaluation) is the appropriate CPT to bill when an occupational therapist provides an evaluation to a patient on an outpatient basis. Code G0129 would not be appropriate to bill for an outpatient occupational therapy evaluation.