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HCPCS G0157: Physical Therapy Assistant Services in Home Health/Hospice

HCPCS Level II code G0157 represents services delivered by a qualified physical therapist assistant in home health or hospice settings, reported in 15-minute units. This code captures supervised rehabilitative assistance provided in patients' residences and supports care continuity for individuals who require therapy outside traditional outpatient clinics. Nationally, accurate use of G0157 matters for care coordination, payment integrity, and tracking utilization of home-based rehabilitative resources.

Key payers included in this national overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code's clinical context, common billing considerations, and the payer mix typically referenced in benchmarking. The publication outlines what is known about service definitions, typical sites of service, and common modifiers that may accompany home health physical therapy assistant services.

This summary equips billing managers, compliance officers, and policy analysts with a clear, national-level reference for G0157, clarifying the code's purpose and the scope of services it represents. Data not available in the input are identified where applicable.

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Billing Code Overview

HCPCS Level II code G0157 describes services performed by a qualified physical therapist assistant in the home health or hospice setting, billed in increments of each 15 minutes. The service type is physical therapy assistance provided by a licensed physical therapist assistant. The typical site of service is the patient's place of residence in a home health or hospice care context.

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HCPCS G0157: Physical Therapy Assistant Services in Home Health/Hospice

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Billing Code Overview

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Clinical & Coding Specifications

Clinical Context

A homebound 78-year-old patient recovering from a recent ischemic stroke receives skilled physical therapy services under a home health plan of care. A qualified physical therapist assistant (PTA) performs therapeutic exercises, gait training, and balance activities during a home visit. Services are timed in 15-minute increments and billed using G0157 for each 15 minutes of PTA time. The clinical workflow includes: initial PT evaluation by a physical therapist establishing goals and plan of care; delegation of selected treatment tasks to the PTA; contemporaneous documentation of time spent on skilled interventions; communication of progress and any changes to the supervising physical therapist; and billing for the PTA time using G0157 with applicable modifier(s) to reflect coverage, therapy caps exceptions, or work status when required.

Coding Specifications

Modifier	Description	When to Use
`GP`	Services delivered under an outpatient physical therapy plan of care	Use when the PTA-delivered therapy is part of a physical therapy plan of care in outpatient or home health contexts where `GP` is required by payer
`QX`	Modifier indicating services performed by a qualified nonphysician practitioner with supervisory requirements met	Use when the PTA services meet Medicare/ payer supervisory requirements and the billing requires identification of a nonphysician performing the service
`QY`	Locum tenens certification modifier for physical therapists (when applicable)	Use sparingly when applicable per payer rules for temporary provider arrangements
`QK`	Medical direction by a physician; more than 4 concurrent direct supervisees (therapy context)	Use when billing requirements require indicating medical direction and supervisory structure per payer policy
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services furnished as primary care	Use if payer requires to indicate alternate provider model in settings that recognize `AS` modifier
`CQ`	Service furnished as part of a therapy assistant visit (HCPCS therapy assistant modifier)	Use to indicate the service was performed by a therapy assistant, commonly appended to `G0157` when payer requires explicit identification
`GP`	(Duplicate entry avoided)	(See above)
`FY`	Left blank in CMS lists for certain uses; payer-specific	Use only if a payer specifically requires `FY` for programmatic reporting (rare)
`GT`	Via interactive audio and video telecommunication systems	Use if a portion of supervisory or synchronous instruction was provided via telehealth modalities allowed by the payer
`22`	Unusual procedural services (increased procedural services)	Use when the PTA provides unusually complex or time-consuming skilled therapy beyond typical expectations; must be supported by documentation
`52`	Reduced services	Use when a planned therapy visit is partially performed, documenting reduced services and medical rationale
`53`	Discontinued procedure	Use when therapy is started but discontinued due to patient instability or other valid reasons

Taxonomy Code	Specialty	Notes
`170500000X`	Physical Therapist (PT)	Supervises and directs PTA care in home health settings
`174100000X`	Physical Therapist Assistant (PTA)	Direct performer of billed `G0157` services in home health or hospice
`251S00000X`	Home Health Agency	Agency billing and oversight entity for home health therapy services
`261QM0800X`	Hospice Care Provider	Providers coordinating hospice-directed supportive PT services

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I69.351`	Dysphagia following cerebral infarction, right dominant side	Swallowing dysfunction commonly seen after stroke; PTAs may address mobility and positioning during feeding safety in home care
`I69.359`	Dysphagia following cerebral infarction, unspecified side	Reflects post-stroke functional impairment that often coexists with mobility deficits managed during PTA home visits
`I69.391`	Hemiplegia and hemiparesis following cerebral infarction, right dominant side	Hemiparesis necessitates gait training, transfer training, and strengthening provided by PTA under `G0157`
`M62.81`	Muscle weakness (generalized)	Generalized weakness in deconditioned homebound patients commonly treated through therapeutic exercise sessions billed with `G0157`
`R26.2`	Difficulty in walking, not elsewhere classified	Primary indication for gait training and balance interventions delivered by PTA in the home setting

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97110`	Therapeutic exercises to develop strength and endurance, range of motion and flexibility; each 15 minutes	Commonly provided by PT or PTA alongside `G0157` to document specific exercise procedures when billed under CPT in non-HCPCS therapy settings
`97112`	Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception; each 15 minutes	Often used in stroke or balance-impaired patients; complements PTA-delivered timed skilled interventions billed with `G0157`
`97116`	Gait training (includes stair training) each 15 minutes	Frequently provided during home health PTA visits for ambulation and safety training; documents the specific procedural element
`97530`	Therapeutic activities, direct one-on-one patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes	Used for functional task training provided by PTA during home visits; documents activity-based interventions
`99509`	Home visit for physical therapy and speech therapy use (not a CPT code for professional services but used in some payer systems)	May appear in payer-specific workflows to denote home visit context; related administratively to `G0157` billing for PTA time

HCPCS G9490: Home Visit Assessment for Non-Homebound Patients

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Influenza Virus Vaccine Administration

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 Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

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

HCPCS G0013: Individual PrEP Counseling and HIV Risk Assessment

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 for Social Determinants of Health

Showing 1–10 of 1996

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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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`GP`	Services delivered under an outpatient physical therapy plan of care	Use when the PTA-delivered therapy is part of a physical therapy plan of care in outpatient or home health contexts where `GP` is required by payer
`QX`	Modifier indicating services performed by a qualified nonphysician practitioner with supervisory requirements met	Use when the PTA services meet Medicare/ payer supervisory requirements and the billing requires identification of a nonphysician performing the service
`QY`	Locum tenens certification modifier for physical therapists (when applicable)	Use sparingly when applicable per payer rules for temporary provider arrangements
`QK`	Medical direction by a physician; more than 4 concurrent direct supervisees (therapy context)	Use when billing requirements require indicating medical direction and supervisory structure per payer policy
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services furnished as primary care	Use if payer requires to indicate alternate provider model in settings that recognize `AS` modifier
`CQ`	Service furnished as part of a therapy assistant visit (HCPCS therapy assistant modifier)	Use to indicate the service was performed by a therapy assistant, commonly appended to `G0157` when payer requires explicit identification
`GP`	(Duplicate entry avoided)	(See above)
`FY`	Left blank in CMS lists for certain uses; payer-specific	Use only if a payer specifically requires `FY` for programmatic reporting (rare)
`GT`	Via interactive audio and video telecommunication systems	Use if a portion of supervisory or synchronous instruction was provided via telehealth modalities allowed by the payer
`22`	Unusual procedural services (increased procedural services)	Use when the PTA provides unusually complex or time-consuming skilled therapy beyond typical expectations; must be supported by documentation
`52`	Reduced services	Use when a planned therapy visit is partially performed, documenting reduced services and medical rationale
`53`	Discontinued procedure	Use when therapy is started but discontinued due to patient instability or other valid reasons

Taxonomy Code	Specialty	Notes
`170500000X`	Physical Therapist (PT)	Supervises and directs PTA care in home health settings
`174100000X`	Physical Therapist Assistant (PTA)	Direct performer of billed `G0157` services in home health or hospice
`251S00000X`	Home Health Agency	Agency billing and oversight entity for home health therapy services
`261QM0800X`	Hospice Care Provider	Providers coordinating hospice-directed supportive PT services

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I69.351`	Dysphagia following cerebral infarction, right dominant side	Swallowing dysfunction commonly seen after stroke; PTAs may address mobility and positioning during feeding safety in home care
`I69.359`	Dysphagia following cerebral infarction, unspecified side	Reflects post-stroke functional impairment that often coexists with mobility deficits managed during PTA home visits
`I69.391`	Hemiplegia and hemiparesis following cerebral infarction, right dominant side	Hemiparesis necessitates gait training, transfer training, and strengthening provided by PTA under `G0157`
`M62.81`	Muscle weakness (generalized)	Generalized weakness in deconditioned homebound patients commonly treated through therapeutic exercise sessions billed with `G0157`
`R26.2`	Difficulty in walking, not elsewhere classified	Primary indication for gait training and balance interventions delivered by PTA in the home setting

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97110`	Therapeutic exercises to develop strength and endurance, range of motion and flexibility; each 15 minutes	Commonly provided by PT or PTA alongside `G0157` to document specific exercise procedures when billed under CPT in non-HCPCS therapy settings
`97112`	Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception; each 15 minutes	Often used in stroke or balance-impaired patients; complements PTA-delivered timed skilled interventions billed with `G0157`
`97116`	Gait training (includes stair training) each 15 minutes	Frequently provided during home health PTA visits for ambulation and safety training; documents the specific procedural element
`97530`	Therapeutic activities, direct one-on-one patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes	Used for functional task training provided by PTA during home visits; documents activity-based interventions
`99509`	Home visit for physical therapy and speech therapy use (not a CPT code for professional services but used in some payer systems)	May appear in payer-specific workflows to denote home visit context; related administratively to `G0157` billing for PTA time

HCPCS G9490: Home Visit Assessment for Non-Homebound Patients

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Influenza Virus Vaccine Administration

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 Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

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

HCPCS G0013: Individual PrEP Counseling and HIV Risk Assessment

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 for Social Determinants of Health

Showing 1–10 of 1996

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

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HCPCS G0157: Physical Therapy Assistant Services in Home Health/Hospice

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Billing Code Overview

OpenPayer

HCPCS G0157: Physical Therapy Assistant Services in Home Health/Hospice

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References