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.

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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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HCPCS G0156: Home Health/Hospice Aide Services, 15-Minute Units

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

Customize your policy alerts

Sign up for hcpcs G0156 policy alerts

Get alerted when payer policies referencing G0156 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

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 Code	Description	Relationship to This Procedure
`G0155`	Services of a clinical social worker under a home health plan of care, each 15 minutes	Social worker visits commonly occur alongside aide care to address psychosocial needs, caregiver support, and discharge planning

Related Modifiers

8 rows

Modifier	Description	When to Use
22	Modifier –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…
23	Modifier -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…
52	Modifier ‑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…
53	Modifier 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…
55	Modifier –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…
62	Modifier 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…
76	Modifier -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…
78	CPT 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 Code	Specialty	Notes
251E00000X	Home Health Agency	A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing se…
253Z00000X	In Home Supportive Care Agency	An 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…
251G00000X	Community Based Hospice Care Agency	Agencies · Hospice Care, Community Based
261QP2000X	Physical Therapy Clinic/Center	An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy i…
2471S1302X	Sonography Radiologic Technologist	A radiologic technologist who specializes in sonography and is appropriately educated and trained, consistent with nationally recognized standards, st…
125J00000X	Dental Therapist	A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the releva…
163WE0900X	Enterostomal Therapy Registered Nurse	Nursing Service Providers · Registered Nurse
374T00000X	Religious Nonmedical Nursing Personnel	Religious 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 Code	Description
B20	Human immunodeficiency virus [HIV] disease
E11.9	Type 2 diabetes mellitus without complications
E78.5	Hyperlipidemia, unspecified
F03.90	Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F32.A	Depression, unspecified
G30.9	Alzheimer's disease, unspecified
I50.9	Heart failure, unspecified
I69.351	Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side
J44.9	Chronic obstructive pulmonary disease, unspecified
K76.9	Liver disease, unspecified

Showing 1–10 of 31

Related Payer Policy Updates

Specialty: Gastroenterology1 / 3

10 rows

Policy	Payer	Effective Date
Esophagogastroduodenoscopy (EGD) Coverage Policy	evicore	2026-11-05
Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)	univerahealthcare	2026-10-15
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing	Oscar Health	2026-10-01
Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease	Oscar Health	2026-10-01
Pancreatic Enzyme Testing for Acute Pancreatitis	Oscar Health	2026-10-01
Helicobacter pylori Testing	Oscar Health	2026-10-01
Celiac Disease Testing	Oscar Health	2026-10-01
Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease	Oscar Health	2026-10-01
Colorectal Cancer Screening	Blue Cross Blue Shield - New Mexico	2026-09-04
Pancreatic Enzyme Testing for Acute Pancreatitis	Blue Cross Blue Shield - New Mexico	2026-09-04

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

Frequently Asked Questions

References

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.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.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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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`G0155`	Services of a clinical social worker under a home health plan of care, each 15 minutes	Social worker visits commonly occur alongside aide care to address psychosocial needs, caregiver support, and discharge planning

Related Modifiers

8 rows

Modifier	Description	When to Use
22	Modifier –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…
23	Modifier -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…
52	Modifier ‑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…
53	Modifier 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…
55	Modifier –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…
62	Modifier 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…
76	Modifier -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…
78	CPT 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 Code	Specialty	Notes
251E00000X	Home Health Agency	A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing se…
253Z00000X	In Home Supportive Care Agency	An 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…
251G00000X	Community Based Hospice Care Agency	Agencies · Hospice Care, Community Based
261QP2000X	Physical Therapy Clinic/Center	An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy i…
2471S1302X	Sonography Radiologic Technologist	A radiologic technologist who specializes in sonography and is appropriately educated and trained, consistent with nationally recognized standards, st…
125J00000X	Dental Therapist	A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the releva…
163WE0900X	Enterostomal Therapy Registered Nurse	Nursing Service Providers · Registered Nurse
374T00000X	Religious Nonmedical Nursing Personnel	Religious 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 Code	Description
B20	Human immunodeficiency virus [HIV] disease
E11.9	Type 2 diabetes mellitus without complications
E78.5	Hyperlipidemia, unspecified
F03.90	Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F32.A	Depression, unspecified
G30.9	Alzheimer's disease, unspecified
I50.9	Heart failure, unspecified
I69.351	Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side
J44.9	Chronic obstructive pulmonary disease, unspecified
K76.9	Liver disease, unspecified

Showing 1–10 of 31

Related Payer Policy Updates

Specialty: Gastroenterology1 / 3

10 rows

Policy	Payer	Effective Date
Esophagogastroduodenoscopy (EGD) Coverage Policy	evicore	2026-11-05
Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)	univerahealthcare	2026-10-15
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing	Oscar Health	2026-10-01
Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease	Oscar Health	2026-10-01
Pancreatic Enzyme Testing for Acute Pancreatitis	Oscar Health	2026-10-01
Helicobacter pylori Testing	Oscar Health	2026-10-01
Celiac Disease Testing	Oscar Health	2026-10-01
Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease	Oscar Health	2026-10-01
Colorectal Cancer Screening	Blue Cross Blue Shield - New Mexico	2026-09-04
Pancreatic Enzyme Testing for Acute Pancreatitis	Blue Cross Blue Shield - New Mexico	2026-09-04

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

Frequently Asked Questions

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS G0156: Home Health/Hospice Aide Services, 15-Minute Units

Sign up for hcpcs G0156 policy alerts

National Reimbursement Benchmarks

OpenPayer

HCPCS G0156: Home Health/Hospice Aide Services, 15-Minute Units

Sign up for hcpcs G0156 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

HCPCS G0156: Home Health/Hospice Aide Services, 15-Minute Units

Sign up for hcpcs G0156 policy alerts

National Reimbursement Benchmarks

HCPCS G0156: Home Health/Hospice Aide Services, 15-Minute Units

Sign up for hcpcs G0156 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code G0156 represent and when is it used?

Which provider types submit claims for G0156?

What are the reported national payer mean reimbursement benchmarks for G0156 and how variable are they?

Which modifiers are referenced for G0156 and in what situations might they apply?

What clinical diagnoses and scenarios commonly support billing G0156?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code G0156 represent and when is it used?

Which provider types submit claims for G0156?

What are the reported national payer mean reimbursement benchmarks for G0156 and how variable are they?

Which modifiers are referenced for G0156 and in what situations might they apply?

What clinical diagnoses and scenarios commonly support billing G0156?

References