G0137 HCPCS - INTENSIVE OUTPATIENT SERVICES; WEEKLY BUNDLE, MINIMUM OF 9 SERVICES OVER A 7 CONTIGUOUS DAY PERIOD, WHICH CAN INCLUDE INDIVIDUAL AND GROUP THERAPY WITH PHYSICIANS OR PSYCHOLOGISTS (OR OTHER MENTAL HEALTH PROFESSIONALS TO THE EXTENT AUTHORIZED UNDER STATE LAW); OCCUPATIONAL THERAPY REQUIRING THE SKILLS OF A QUALIFIED OCCUPATIONAL THERAPIST; SERVICES OF SOCIAL WORKERS, TRAINED PSYCHIATRIC NURSES, AND OTHER STAFF TRAINED TO WORK WITH PSYCHIATRIC PATIENTS; INDIVIDUALIZED ACTIVITY THERAPIES THAT ARE NOT PRIMARILY RECREATIONAL OR DIVERSIONARY; FAMILY COUNSELING (THE PRIMARY PURPOSE OF WHICH IS TREATMENT OF THE INDIVIDUAL'S CONDITION); PATIENT TRAINING AND EDUCATION (TO THE EXTENT THAT TRAINING AND EDUCATIONAL ACTIVITIES ARE CLOSELY AND CLEARLY RELATED TO INDIVIDUAL'S CARE AND TREATMENT); DIAGNOSTIC SERVICES; AND SUCH OTHER ITEMS AND SERVICES (EXCLUDING MEALS AND TRANSPORTATION) THAT ARE REASONABLE AND NECESSARY FOR THE DIAGNOSIS OR ACTIVE TREATMENT OF THE INDIVIDUAL'S CONDITION, REASONABLY EXPECTED TO IMPROVE OR MAINTAIN THE INDIVIDUAL'S CONDITION AND FUNCTIONAL LEVEL AND TO PREVENT RELAPSE OR HOSPITALIZATION, AND FURNISHED PURSUANT TO SUCH GUIDELINES RELATING TO FREQUENCY AND DURATION OF SERVICES IN ACCORDANCE WITH A PHYSICIAN CERTIFICATION AND PLAN OF TREATMENT (PROVISION OF THE SERVICES BY A MEDICARE-ENROLLED OPIOID TREATMENT PROGRAM); LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE

Code Information

  • HCPCS Code: G0137
  • Sequence Number: 0010
  • Short Description: Inten outpt svs,min 9 pr 7 d
  • Long Description: Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skills of a qualified occupational therapist; services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individual's condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individual's care and treatment); diagnostic services; and such other items and services (excluding meals and transportation) that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services in accordance with a physician certification and plan of treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
  • Date Added: 1/1/2024
  • Action Code: N - No maintenance for this code
  • Action Effective Date: 1/1/2024
  • Classification: Temporary Procedures & Professional Services
  • Coding System: HCPCS

Code Type

  • Berenson-Eggers Type Of Service Code: M5D - Specialist - other
  • Type Of Service Code:
    • 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Billing Information

  • Pricing Indicator Code:
    • 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
  • Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
  • Coverage Issues Manual Reference Section Number:
      N/A
    • Medicare Carriers Manual Reference Section Number:
        N/A
      • Coverage Code: C - Carrier judgment

      HCPCS Record

      Field Name Field Value
      Healthcare Common Procedure Coding System Code G0137
      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 Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skills of a qualified occupational therapist; services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individual's condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individual's care and treatment); diagnostic services; and such other items and services (excluding meals and transportation) that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services in accordance with a physician certification and plan of treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
      HCPCS Short Description Inten outpt svs,min 9 pr 7 d
      HCPCS Pricing Indicator Code 1 13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
      HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
      HCPCS Coverage Code C - Carrier judgment
      HCPCS Berenson-Eggers Type Of Service Code M5D - Specialist - other
      HCPCS Type Of Service Code 1 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
      HCPCS Anesthesia Base Unit Quantity 0
      HCPCS Code Added Date 1/1/2024
      HCPCS Action Effective Date 1/1/2024
      HCPCS Action Code N - No maintenance for this code

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      This page was last updated on: 7/1/2024