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HCPCS code G0158: OT assistant, per 15 minutes2026 Medicare rate & RVUs

Reports each 15-minute unit of occupational therapy furnished by a qualified occupational therapist assistant in a home health or hospice setting.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · G0158

OT assistant, per 15 minutes

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for G0158 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What G0158 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What G0158 covers

G0158 identifies occupational therapy services furnished by a qualified occupational therapist assistant in a home health or hospice setting. It is reported for each 15-minute unit of assistant-delivered service, distinguishing this code from occupational therapy furnished by an occupational therapist and from physical therapy services. Home health and hospice agencies report the service when it is furnished by the qualified assistant.

CMS assigns the code physician fee schedule status E, excluding it from the physician fee schedule. Medicare Part B does not separately price the service. When Medicare covers it, payment is under another payment method, and coverage is left to the Medicare contractor’s judgment. Each unit represents 15 minutes of occupational therapist assistant services.

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 G0158 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

G0158 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

G0158 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
G0158 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the G0158 rate is calculated

Each of G0158’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 · G0158

RVUs × geographic indexes × conversion factor

Office or facility?

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 G0158

G0158 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 · G0158

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

G0158 isn’t priced in this setting.

G0158 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • G0158

    OT assistant, per 15 minutes0 wRVU

    Not priced

  • G0152

    Occupational therapy, home health or hospice, per 15 minutes0 wRVU

    Not priced

  • G0157

    PT assistant services, per 15 minutes0 wRVU

    Not priced

  • G0151

    Home health PT, qualified therapist, per 15 minutes0 wRVU

    Not priced

How to choose

G0152Occupational therapyHome health or hospice, per 15 minutes
G0158 is for services furnished by a qualified occupational therapist assistant; G0152 is for services furnished by an occupational therapist.
G0157PT assistant servicesPer 15 minutes
G0157 identifies home health physical therapy assistant services. G0158 identifies occupational therapy assistant services.
G0151Home health PTQualified therapist, per 15 minutes
G0151 identifies home health physical therapy furnished by a qualified physical therapist; G0158 is for occupational therapy furnished by an assistant.

Codes related to G0158

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to G0158
CodeHow it relatesNational office range
Used instead
G0152Occupational therapy, home health or hospice, per 15 minutesOccupational therapy furnished by an occupational therapist rather than an assistant.No office rate
G0160Home health OT, maintenance, per 15 minutesHome health occupational therapy furnished by an occupational therapist rather than an assistant.No office rate
Same family
G0157PT assistant services, per 15 minutesParallel home health assistant code for physical therapy, reported in 15-minute units.No office rate

G0158 billing questions

When should G0158 be used instead of G0152?

Use G0158 for occupational therapy services furnished by a qualified occupational therapist assistant. G0152 is for services furnished by an occupational therapist.

How many minutes does one unit represent?

One unit represents 15 minutes of occupational therapist assistant services.

Does Medicare separately price G0158 under Part B?

No. Medicare Part B does not separately price the service. When Medicare covers it, payment is under another payment method.

Does status E mean the service is never covered?

No. Status E excludes the code from the physician fee schedule. Coverage is left to the Medicare contractor’s judgment, and covered services are paid under another payment method.

What service time does a G0158 claim represent?

Each unit represents 15 minutes of occupational therapy services furnished by a qualified occupational therapist assistant in a home health or hospice setting.

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

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