What insurance policy changes affect HCPCS G0152?

There are 11 tracked policy changes affecting HCPCS G0152, including updates from Aetna, UnitedHealthcare, CareSource. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS G0152?

Payers that have issued tracked updates for HCPCS G0152 include: Aetna, UnitedHealthcare, CareSource, Connecticut Medicaid (HUSKY Health), Humana, Kansas Medicaid (KanCare).

How do I get notified when HCPCS G0152 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS G0152. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for HCPCS G0152?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

G0152 — Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes: Insurance Policy Changes

G0152 Insurance Policy Changes

HCPCS G0152 is officially defined as "Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes." HCPCS G0152 is referenced in 11 tracked payer policy changes from Aetna, UnitedHealthcare, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS G0152 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

DSS Important Message - Incorrect PA Effective Date in the SAM System - Duplicate HH Procedure Codes pdf

Connecticut Medicaid (HUSKY Health)·Identified Jun 20, 2026

Gainwell Technologies is experiencing a system issue causing home health prior authorization effective dates to incorrectly display as 05/12/2023 in the SAM system for specific procedure codes from 03/30/2023 forward. Additionally, some home health procedure codes may have been duplicated in error during an EVV system update, requiring providers to verify rates are attached to avoid billing issues.

G0152 Insurance Policy Changes

OfficeLink Updates - October 2025 notices and reminders (PDF)

Massachusetts Medicaid: Prior authorization, HCPCS coding and member ID updates

Massachusetts Medicaid: Prior authorization, HCPCS coding and member ID updates

[Ohio] Dates Announced: ODM to Roll Out EVV Claims Processing Changes in Seven Phases

[Ohio] Navigating EVV Claims Success: Join Our Office Hours for Claim Guidance

[Ohio] Dates Announced: ODM to Roll Out EVV Claims Processing Changes in Seven Phases

DSS Important Message - Incorrect PA Effective Date in the SAM System - Duplicate HH Procedure Codes pdf

Home Health - MEDICAID - INDIANA (New)

KMAP BULLETIN: HCBS Brain Injury Waiver – Cognitive Therapy Code Update

KMAP BULLETIN: Updated - HCBS Rate Increase for Fiscal Year 2026

KMAP BULLETIN: Implementation of Virtual Delivery of Services Across All HCBS Waivers