HCPCS code G0159: PT maintenance, per 15 minutes2026 Medicare rate & RVUs in Texas
Reports qualified physical therapist time spent establishing or delivering a safe, effective maintenance program for a patient in the home health setting.
CMS doesn’t publish an office rate for G0159 in Texas.
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 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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
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
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
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.
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
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