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HCPCS G0160

HCPCS Level II

Hhc occup therapy ea 15

No national payment amount

Status E is not separately payable under the PFS.

Excluded from the PFS by regulation. Not payable under the PFS.

Common questions

Why is there no payment amount for G0160?

Its status indicator is E (excluded). Excluded from the PFS by regulation. Not payable under the PFS. The blank is deliberate: the amount is unknown or paid another way, not zero.

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October). Each release is versioned here, so past quarters stay lookupable — see what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Saw this code on your bill?

What is a G0160 visit in patient-friendly terms?

In plain terms: Hhc occup therapy ea 15 You'll typically see HCPCS G0160 on a bill or explanation of benefits (EOB) when a clinician performs or bills for this service.

How this amount is computed

amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000.

Release Q3 2026

Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A value of blank means CMS publishes no national number for that part — which is not the same as zero.

Rate history by release

National non-facility amount for G0160 across quarterly releases.

$1 $1 $0 $-1 $-1 Q1 2025 · $0.00 Q2 2025 · $0.00 Q3 2025 · $0.00 Q4 2025 · $0.00 Q1 2026 · $0.00 Q2 2026 · $0.00 Q3 2026 · $0.00 Q1 2025 Q2 2025 Q3 2025 Q1 2026 Q2 2026 Q3 2026
Non-facility Facility
Release Status Non-facility Facility
Q3 2026 Jun 30, 2026 E $0.00 $0.00
Q2 2026 Mar 10, 2026 E $0.00 $0.00
Q1 2026 Dec 29, 2025 E $0.00 $0.00

Billing together (NCCI edits)

NCCI Q3 2026

Per CMS's National Correct Coding Initiative. Hover a code for when it's used.

Never billable with G0160 on the same date of service

36591 36592 96523 97161 - Physical Therapy Evaluation, Low Complexity 97162 97163 97164

Billable with G0160 only with modifier 59, XE, XS, XP, or XU

97150 97165 97166 97167 97168 97530 - Therapeutic Activities, Per 15 Minutes 97533 97535 97542 97545 97750

Source & method

Computed from the CMS Medicare Physician Fee Schedule Q3 2026 release (schedule pfs, effective July 2026). National amounts apply a GPCI of 1.000 and exclude sequestration. Payability follows the status indicator, not RVU values — blank RVUs are never treated as zero. Releases are immutable; a rate retrieved for a past quarter always reflects that release. Code descriptions for HCPCS Level II are CMS-owned.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 15,053)

Conversion factor $33.4009 read from the same file, row 11, column 26.

Use the (i) buttons next to each amount above for the exact row, columns, and math.