G0040 – Patient already receiving physical/occupational/speech/recreational therapy during the measurement period

Long description

Patient already receiving physical/occupational/speech/recreational therapy during the measurement period

Short description

Pt phys/occ therapy

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

Z2 Undefined codes

Added

January 1, 2022

Last change

January 1, 2022 – No change

Nearby G codes

• G0032 – Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics
• G0033 – Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement period and the ipsd for benzodiazepines
• G0034 – Patients receiving palliative care during the measurement period
• G0035 – Patient has any emergency department encounter during the performance period with place of service indicator 23
• G0036 – Patient or care partner decline assessment
• G0037 – On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available
• G0038 – Clinician determines patient does not require referral
• G0039 – Patient not referred, reason not otherwise specified
• G0041 – Patient and/or care partner decline referral
• G0042 – Referral to physical, occupational, speech, or recreational therapy
• G0043 – Patients with mechanical prosthetic heart valve
• G0044 – Patients with moderate or severe mitral stenosis
• G0045 – Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention
• G0046 – Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention
• G0047 – Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed
• G0048 – Patients who receive palliative care services any time during the intake period through the end of the measurement year