| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
G0176 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) |
| HCPCS Short Description |
Opps/php;activity therapy |
| HCPCS Pricing Indicator Code 1 |
00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) |
| HCPCS Multiple Pricing Indicator Code |
9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') |
| HCPCS Coverage Code |
D - Special coverage instructions apply |
| HCPCS Processing Note Number |
0102 |
| HCPCS Berenson-Eggers Type Of Service Code |
Y2 - Other - non-Medicare fee schedule |
| HCPCS Type Of Service Code 1 |
U - Occupational therapy |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2001 |
| HCPCS Action Effective Date |
1/1/2001 |
| HCPCS Action Code |
N - No maintenance for this code |