Anthem Blue Cross and Blue Shield Virginia policy
CG-REHAB-12 Rehabilitative and Habilitative Services in the Home Setting: Physical Medicine/Physical Therapy, Occupational Therapy and Speech-Language Pathology
CG-REHAB-12 Rehabilitative and Habilitative Services in the Home Setting: Physical Medicine/Physical Therapy, Occupational Therapy and Speech-Language Pathology is a public Anthem Blue Cross and Blue Shield Virginia policy (policy CG-REHAB-12). It lists 13 CPT or HCPCS codes, 13 of them on the Anthem Blue Cross and Blue Shield Virginia prior authorization list. Not a coverage decision; the payer's own document governs.
- Policy number
- CG-REHAB-12
- Line of business
- Commercial
- Source
- www.anthem.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Prior authorization status is from the Anthem Blue Cross and Blue Shield Virginia prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield Virginia policies |
|---|---|---|---|
| G0151 | On the list | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | Policies naming G0151 |
| G0152 | On the list | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Policies naming G0152 |
| G0153 | On the list | Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes | Policies naming G0153 |
| G0157 | On the list | Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes | Policies naming G0157 |
| G0158 | On the list | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Policies naming G0158 |
| G0159 | On the list | 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 | Policies naming G0159 |
| G0160 | On the list | 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 | Policies naming G0160 |
| G0161 | On the list | 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 m | Policies naming G0161 |
| G2168 | On the list | Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes | Policies naming G2168 |
| G2169 | On the list | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 | Policies naming G2169 |
| S9128 | On the list | Speech Therapy, In The Home | Policies naming S9128 |
| S9129 | On the list | Occupational Therapy, In The | Policies naming S9129 |
| S9131 | On the list | Physical therapy, in the home, per diem | Policies naming S9131 |
All Anthem Blue Cross and Blue Shield Virginia policies · Anthem Blue Cross and Blue Shield Virginia prior authorization CPT list