HCPCS code G0161: Speech therapy, maintenance, per 15 minutes2026 Medicare rate & RVUs in Florida
Reports a qualified speech-language pathologist’s home health service to establish or deliver a safe speech-language pathology maintenance program in 15-minute units.
CMS doesn’t publish an office rate for G0161 in Florida.
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 G0161 covers
G0161 represents home health speech-language pathology directed to establishing or delivering a safe, effective maintenance program. A qualified speech-language pathologist performs the service in the home health setting. Its maintenance-program purpose distinguishes it from the general home health speech-language pathology service code; the discipline, setting, and purpose together identify the service.
Medicare assigns G0161 physician fee schedule status E, excluding it from the physician fee schedule by regulation. The HCPCS pricing method classifies 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. The code is reported in 15-minute units, matching the stated service interval. G0159 and G0160 identify home health physical and occupational therapy maintenance services, respectively, while G0153 identifies home health speech-language pathology services without the specific maintenance-program distinction.
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 G0161 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | Unavailable |
| Miami, FL | Unavailable | Unavailable |
| Rest of Florida | Unavailable | Unavailable |
How the G0161 rate is calculated
Each of G0161’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 · G0161
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 G0161
G0161 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 · G0161
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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G0161 isn’t priced in this setting.
G0161 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0153Speech-language servicePer 15 minutes
- G0161 identifies home health speech-language pathology to establish or deliver a maintenance program. G0153 describes home health speech-language pathology services without that specific distinction.
- G0159PT maintenancePer 15 minutes
- G0159 identifies home health physical therapy maintenance; G0161 identifies home health speech-language pathology maintenance.
- G0160Home health OTMaintenance, per 15 minutes
- G0160 identifies home health occupational therapy maintenance; G0161 identifies home health speech-language pathology maintenance.
G0161 billing questions
How does G0161 differ from G0153?
G0161 identifies home health speech-language pathology to establish or deliver a safe, effective maintenance program. G0153 describes home health speech-language pathology services without that specific maintenance-program distinction.
How many minutes does one unit represent?
One unit represents 15 minutes of service.
Who performs the service reported with G0161?
A qualified speech-language pathologist performs the service in the home health setting.
Does Medicare separately price G0161 under Part B?
No. It is not separately priced by Medicare Part B and has physician fee schedule status E. When Medicare covers the service, payment is made under another payment method.
Who determines whether Medicare covers G0161?
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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