§ 9789.93Table A

Rates are effective for service on or after (effective date of regulations).

Code / Description / Rate per
15 min.
Increment / Rate per hour / Rate per Diem
G0151 / Services performed by a qualified physical therapist in the home health setting, each 15 minutes / 50.46
52.93
G0152 / Services performed by a qualified occupational therapist in the home health setting, each 15 minutes / 50.95
53.43
G0153 / Services performed by a qualified speech-language pathologist in the home health setting, each 15 minutes / 51.43
53.94
G0155 / Services of clinical social worker in home health setting, each 15 minutes / 61.62
64.56
G0156 / Services of home health aide in home health setting, each 15 minutes / 6.79
9.81
G0157 / Services performed by a qualified physical therapist assistant in the home health setting, each 15 minutes / 24.75
25.93
G0158 / Services performed by a qualified occupational therapist assistant in the home health setting, each 15 minutes / 25.72
27.00
G0159 / Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes / 49.05
G0160 / Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes / 55.25
G0161 / Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes / 115.03
Code / Description / Rate per
15 min.
Increment / Rate per hour / Rate per Diem
G0162 / Skilled services by a registered nurse (RN) for management and evaluation of the plan of care; each 15 minutes (the patient’s underlying condition or complication requires an RN to ensure that essential non-skilled care achieves its purpose in the home health setting) / 40.32
G0163 / Skilled services of a licensed nurse (LPN or RN) for the observation and assessment of the patient’s condition, each 15 minutes (the patient’s condition requires skilled nursing personnel to identify and evaluate the patient’s need for possible modification of treatment in the home health setting) / 40.31
G0164 / Skilled services of a licensed nurse (LPN or RN), in the training and/or education of a patient or family member, in the home health setting, each 15 minutes / 29.12
IHSS200 / Chore services, in the home, per 15-minutes / 3.84
S5125 / Attendant care services, per 15 minutes* / 4.37
4.55
S5126 / Attendant care services, per diem* / 140.22
146.11
S9122 / Home health aide or certified nurse assistant, providing care in the home; per 15 minutes / 6.31
S9123 / Nursing care, in the home; by registered nurse, per 15 minuteshour / 27.54 / 114.76
S9124 / Nursing care, in the home, by licensed practical nurse, per 15 minuteshour / 22.08 / 92.01
S9470 / Nutritional counseling, dietitian visit (up to 2 hours)
T1001 / Nursing assessment/evaluation / 40.64 / 177.43
T1030 / Nursing care, in the home, by registered nurse, per diem / 661.33
689.11
T1031 / Nursing care, in the home, by licensed practical nurse, per diem / 529.35
551.59

*”Attendantcare services,” here, for billing purposes only,includes personal care and domestic care services as set forth in the “Home Health Care Services” topic of the MTUS.

Authority: Sections 133, 4603.5, 5307.1, 5307.3 and 5307.8, Labor Code.

Reference: Sections 4600, 5307.1, 5307.811 and 5307.118, Labor Code.

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Home Health Care Services Fee Schedule Regulations(October 2015MaySeptember2016)

California Code of Regulations, title 8, sections 9789.90-9789.93