Functional G-Codes (PT/OT/SLP)

Therapy Functional Reporting G Codes began on Jan. 1, 2013. CMS (Centers for
Medicare & Medicaid Services) has allowed for a trial reporting period, meaning that therapists would not be penalized for incorrectly submitting or omitting G-codes until July 1, 2013.If G-codes are not properly submitted in documentation and billing after this date, therapists services claims will not be paid.

Functional Reporting is required of:
-Skilled Nursing Facilities (for beneficiaries in a Part B stay)
-Rehabilitation Agencies
-Home Health Agencies (for beneficiaries who are not under a Home Health plan of care,
are not homebound, and whose therapy or other services are not paid under the Home
Health prospective payment system)
-CORFs (PT, OT, and SLP services)
-Hospitals, including beneficiaries in Outpatient and Emergency Departments, and
inpatients paid under Part B
-Critical Access Hospitals
-Therapists in Private Practice: Physical Therapists (PTs), Occupational Therapists (OTs),
and Speech Language Pathologists (SLPs)
-Physicians: Medical Doctors (MDs), Doctors of Osteopathy (DOs), Doctors of Podiatric
Medicine (DPMs), and Doctors of Optometry (ODs)
-NPPs: Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), and Physician
Assistants (PAs)

This Application will help therapist understand billing for G-codes and remain complaint with CMS.
G-Codes with short descriptors,Severity/Complexity Modifiers and some Functional Test and Measurement Tools are summarized in one page for easy access/reference.