HCPCS code G0155: Social work, home health or hospice2026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What G0155 covers

G0155 represents clinical social work in a home health or hospice setting. A clinical social worker may address a patient’s psychosocial needs, coping with illness, family or caregiver concerns, and connection to community resources. The home health agency or hospice reports the service when its clinical social worker provides care in that setting; this is distinct from physical, occupational, or speech-language therapy and aide services.

Medicare assigns G0155 status X, meaning the physician fee schedule does not pay it because it is not a physician service under the Medicare statute. It is not separately priced by Medicare Part B; when covered, payment is through another fee schedule or payment system. Coverage is left to the Medicare contractor’s judgment. The code represents each 15 minutes of service.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where G0155 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

G0155 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the G0155 rate is calculated

Each of G0155’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for G0155

G0155 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

G0155 compared with similar codes

How to choose

G0151Home health PTQualified therapist, per 15 minutes

Use G0155 for clinical social work in home health or hospice. G0151 identifies home health physical therapy services.

G0152Occupational therapyHome health or hospice, per 15 minutes

G0155 identifies clinical social worker services; G0152 identifies home health occupational therapy services.

G0156Aide servicesPer 15 minutes

G0155 is for clinical social work. G0156 is for home health aide services.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates