HCPCS code G0157: PT assistant services, per 15 minutes2026 Medicare rate & RVUs in Washington
Reports physical therapy services furnished by a qualified physical therapist assistant in a home health or hospice setting, in 15-minute units.
CMS doesn’t publish an office rate for G0157 in Washington.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What G0157 covers
G0157 reports services furnished by a qualified physical therapist assistant in a home health or hospice setting. The service is physical therapy delivered by the assistant, and the code distinguishes it from services furnished by a physical therapist. It also separates physical therapy assistant services from occupational therapy assistant services. Each unit represents 15 minutes of assistant services. The service setting is home health or hospice care.
CMS excludes G0157 from the physician fee schedule by regulation under status E. HCPCS pricing lists it as not separately priced by Medicare Part B. When Medicare covers the service, payment is made under another payment method. Coverage is left to the Medicare contractor’s judgment.
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 G0157 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| King County, WA | Unavailable | Unavailable |
| Rest of Washington | Unavailable | Unavailable |
How the G0157 rate is calculated
Each of G0157’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.
How the rate is built · G0157
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0157
G0157 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.
Place of service · G0157
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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G0157 isn’t priced in this setting.
G0157 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0151Home health PTQualified therapist, per 15 minutes
- G0151 identifies services furnished by a qualified physical therapist; G0157 identifies services furnished by a qualified physical therapist assistant.
- G0159PT maintenancePer 15 minutes
- G0159 identifies home health or hospice physical therapy for maintenance therapy. G0157 identifies services furnished by a qualified physical therapist assistant.
- G0158OT assistantPer 15 minutes
- G0158 is for occupational therapy assistant services. G0157 is for physical therapy assistant services.
G0157 billing questions
When should I report this instead of G0151?
Use G0157 for services furnished by a qualified physical therapist assistant. G0151 identifies services furnished by a qualified physical therapist.
How many minutes does one unit represent?
One unit represents 15 minutes of physical therapist assistant services.
Is this code separately priced under Medicare Part B?
No. CMS lists it as excluded from the physician fee schedule and not separately priced by Medicare Part B. When Medicare covers the service, payment is made under another payment method.
Who determines whether Medicare covers the service?
Coverage is left to the Medicare contractor’s judgment.
How does this differ from G0159?
G0159 identifies home health or hospice physical therapy services for maintenance therapy. G0157 identifies services furnished by a qualified physical therapist assistant.
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
Fee sheets · Coming soon
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