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    v1.0.28
    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-g0156-home-health-hospice-aide-15-minutes
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    HCPCS G0156: Home Health/Hospice Aide Services, 15-Minute Units

    Commercial payers pay $12 on average nationally for this procedure.

    HCPCS Level II code G0156 describes services of a home health or hospice aide, billed in 15-minute units for direct personal care provided in the patient’s home or hospice residence; this code captures aide time spent on tasks such as personal care, activities of daily living assistance, and other non-skilled supportive services as part of home health or hospice care plans.

    For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease.

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    National Reimbursement Benchmarks

    National commercial reimbursement for HCPCS G0156 centers around an average commercial benchmark of $12.4 under BUCA, with payers showing meaningful dispersion in central tendency and upper-end payments. Blue Cross Blue Shield’s mean of $18.4 and a high max of $119.5 pull its distribution upward; Aetna and Cigna present tighter central ranges near $10.1 and $9.4 respectively, while UnitedHealth Group’s mean of $5.9 and many zero percentiles indicate a concentration at low or no payment for a substantial portion of markets.

    Examining interquartile dispersion (P75 minus P25) highlights variation: Blue Cross Blue Shield’s IQR is $11.4 (P75 $19.6 minus P25 $8.2), the widest among payers with available quartiles, reflecting broad regional or contract-driven spread. Aetna’s IQR is $0 ($10.0 minus $10.0), the tightest, followed by Cigna with an IQR of $4.4 ($9.2 minus $4.8); UnitedHealth Group shows an IQR of $0 but with median and lower quartiles at $0, signaling concentration at the low end rather than narrow paid rates.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A homebound 82-year-old female with advanced chronic obstructive pulmonary disease and progressive functional decline is discharged from a hospital to home with a home health plan of care. She is largely bed-confined (Z74.01) and requires continuous supervision due to intermittent confusion and risk of falls (Z74.3). A home health aide provides direct personal care visits in 15-minute units (G0156) to assist with activities of daily living (bathing, dressing, toileting), safe transfers, skin checks, and reinforcement of the plan of care established by the nurse and physician. The aide documents each 15-minute encounter, notifies the supervising nurse of changes (wounds, weight loss, medication adherence), and coordinates with the interdisciplinary team for aftercare needs (Z48.89), palliative care goals (Z51.5), and caregiver dependency issues (Z74.8). Billing is submitted by a certified Home Health Agency (251E00000X) or an In Home Supportive Care program (253Z00000X) using G0156 in 15-minute increments per patient encounter.

    Related CPT Codes

    CPT CodeDescription

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    251E00000XHome Health AgencyA public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing se…
    253Z00000XIn Home Supportive Care AgencyAn In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provi…
    251G00000XCommunity Based Hospice Care AgencyAgencies · Hospice Care, Community Based
    261QP2000XPhysical Therapy Clinic/CenterAn entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy i…
    2471S1302XSonography Radiologic TechnologistA radiologic technologist who specializes in sonography and is appropriately educated and trained, consistent with nationally recognized standards, st…
    125J00000XDental TherapistA Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the releva…
    163WE0900XEnterostomal Therapy Registered NurseNursing Service Providers · Registered Nurse
    374T00000XReligious Nonmedical Nursing PersonnelReligious nonmedical nursing personnel are experienced in caring for the physical needs of nonmedical patients. For example, caring for the physical …

    Related ICD-10-CM Codes

    31 rows

    ICD-10-CM CodeDescription
    B20Human immunodeficiency virus [HIV] disease
    E11.9Type 2 diabetes mellitus without complications
    E78.5Hyperlipidemia, unspecified
    F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F32.ADepression, unspecified
    G30.9Alzheimer's disease, unspecified
    I50.9Heart failure, unspecified
    I69.351Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side
    J44.9Chronic obstructive pulmonary disease, unspecified
    K76.9Liver disease, unspecified

    Showing 1–10 of 31

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01
    Celiac Disease TestingOscar Health2026-10-01
    Laboratory Testing for the Diagnosis of Inflammatory Bowel DiseaseOscar Health2026-10-01
    Percutaneous Electrical Nerve Field Stimulation (PENFS)Cigna2026-09-15
    Colorectal Cancer ScreeningBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    HCPCS-G9490-HOME-ASSESSMENT-NON-HOMEBOUND

    HCPCS G9490: Home Visit Patient Assessment for Non-Homebound Beneficiary

    HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

    HCPCS G0008: Administration of Influenza Virus Vaccine

    HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

    HCPCS G0009: Administration of Pneumococcal Vaccine

    HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

    HCPCS G0010: Administration of Hepatitis B Vaccine

    HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

    HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

    HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

    HCPCS G0012: Injection of PrEP Drug for HIV Prevention

    HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

    HCPCS G0013: Individual PrEP Counseling by Clinical Staff

    HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

    HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

    HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

    HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

    HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

    HCPCS G0019: Community Health Integration, Person-Centered Assessment

    Showing 1–10 of 1996

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Relationship to This Procedure
    G0155Services of a clinical social worker under a home health plan of care, each 15 minutesSocial worker visits commonly occur alongside aide care to address psychosocial needs, caregiver support, and discharge planning