2025 HCPCS code G2169
Effective Date: N/A Therapy Maintenance Program in Home Health Setting Feed
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 minutes.
Medical necessity for G2169 requires that the services are considered reasonable and necessary for the treatment of the patient’s condition. The services must be provided by a qualified occupational therapy assistant under the supervision of a qualified occupational therapist. The occupational therapy maintenance program must be established and regularly reviewed by the supervising occupational therapist.
A qualified occupational therapist assistant provides services for a homebound patient to ensure the maintenance of health and functional ability. These services include helping the patient to maintain or improve physical, emotional, or psychological advances made during previous therapy and to remain independent in activities of daily living. The occupational therapist assistant also assists the patient with transfers from bed to wheelchair and vice versa, if necessary. The time that a qualified occupational therapy assistant actively invests in the patient is the reporting time, which is 15 minutes per unit of service. The minimum time spent for the service should be eight minutes.
In simple words: This code represents 15 minutes of in-home occupational therapy provided by a therapist's assistant to help a patient maintain the progress they've made in earlier therapy sessions, allowing them to stay independent at home.
This code covers occupational therapy maintenance services provided by a qualified occupational therapist assistant for a patient in their home, billed in 15-minute increments. The minimum time spent for the service should be eight minutes. These services are part of a maintenance program focusing on sustaining or improving the patient's health and functional abilities achieved through prior therapy and promoting independence in daily living activities. This can include assistance with transfers (e.g., bed to wheelchair). The reported time reflects the qualified occupational therapy assistant's active engagement with the patient.
Example 1: A patient recovering from a stroke receives ongoing occupational therapy at home. The occupational therapist assistant visits the patient for 30 minutes (two units) to work on exercises for upper extremity function and to practice dressing techniques., An elderly patient with arthritis requires assistance maintaining their range of motion and performing daily tasks. The occupational therapist assistant visits three times a week, each time for 45 minutes (three units), to assist with exercises, adaptive techniques, and home modifications to enhance safety and independence., A patient with a chronic illness experiences a decline in function. The occupational therapist assistant provides 15 minutes (one unit) of maintenance therapy in the home to review and reinforce previously learned strategies and ensure the patient can continue performing essential activities of daily living.
Documentation should include the start and end times of the therapy session, the total time spent with the patient, a detailed description of the interventions provided, the patient's response to the treatment, and any progress or challenges encountered.
- Specialties:Occupational Therapy, Home Health
- Place of Service:Home