G0162 Insurance Policy Changes

HCPCS G0162 is officially defined as "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 or hospice setting)." HCPCS G0162 is referenced in 4 tracked payer policy changes from Aetna and Connecticut Medicaid (HUSKY Health). For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS G0162 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.