HCPCS code G0158: OT assistant, per 15 minutes2026 Medicare rate & RVUs in Guam
Reports each 15-minute unit of occupational therapy furnished by a qualified occupational therapist assistant in a home health or hospice setting.
CMS doesn’t publish an office rate for G0158 in Guam.
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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On this page 9 sections
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.
G0158 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
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
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
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G0158 isn’t priced in this setting.
G0158 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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