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HCPCS code G0159: PT maintenance, per 15 minutes2026 Medicare rate & RVUs

Reports qualified physical therapist time spent establishing or delivering a safe, effective maintenance program for a patient in the home health setting.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · G0159

PT maintenance, 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 G0159 →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 G0159 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 G0159 covers

G0159 describes time a qualified physical therapist spends establishing or delivering a safe and effective physical therapy maintenance program in the home health setting. The service is directed at maintaining the patient's function through a planned program, rather than simply identifying the discipline as physical therapy. Home health agencies report it for the qualified therapist's work on that maintenance program.

Medicare excludes G0159 from the physician fee schedule under status E. The HCPCS file does not separately price it under Medicare Part B; when Medicare covers the service, payment is through another method. Coverage is left to the Medicare contractor's judgment. Report the service in 15-minute units, corresponding to the therapist's time spent establishing or delivering the maintenance program.

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 G0159 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

G0159 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

G0159 rates by state

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

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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
G0159 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 G0159 rate is calculated

Each of G0159’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 · G0159

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 G0159

G0159 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 · G0159

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

G0159 isn’t priced in this setting.

G0159 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • G0159

    PT maintenance, per 15 minutes0 wRVU

    Not priced

  • G0151

    Home health PT, qualified therapist, per 15 minutes0 wRVU

    Not priced

  • G0157

    PT assistant services, per 15 minutes0 wRVU

    Not priced

  • G0160

    Home health OT, maintenance, per 15 minutes0 wRVU

    Not priced

How to choose

G0151Home health PTQualified therapist, per 15 minutes
G0159 identifies qualified physical therapist time establishing or delivering a maintenance program. G0151 reports home health physical therapy services without that maintenance-program distinction.
G0157PT assistant servicesPer 15 minutes
G0159 is for services performed by a qualified physical therapist; G0157 identifies home health physical therapist assistant services.
G0160Home health OTMaintenance, per 15 minutes
G0160 is for home health occupational therapy, not physical therapy maintenance-program services.

Codes related to G0159

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

Codes related to G0159
CodeHow it relatesNational office range
Used instead
G0151Home health PT, qualified therapist, per 15 minutesHome health physical therapy service code when reporting therapy not specifically identified as maintenance-program work.No office rate
G0157PT assistant services, per 15 minutesHome health physical therapist assistant services, rather than work performed by the qualified physical therapist.No office rate

G0159 billing questions

When should G0159 be used instead of G0151?

Use G0159 for qualified physical therapist time establishing or delivering a safe and effective maintenance program. G0151 is the home health physical therapy service code when the service is not being reported specifically as maintenance-program work.

Can G0159 be reported for a physical therapist assistant?

G0159 identifies services performed by a qualified physical therapist. G0157 is the home health code for physical therapist assistant services.

How many minutes does one unit represent?

Each unit represents 15 minutes of the qualified physical therapist's maintenance-program work.

Does Medicare separately price G0159 under Part B?

No. CMS excludes it from the physician fee schedule and lists it as not separately priced by Medicare Part B. When Medicare covers the service, payment is under another method.

Who determines whether Medicare covers G0159?

Coverage is left to the Medicare contractor's judgment.

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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