2025 HCPCS code G9478
Effective Date: N/A Procedures / Professional Services - Additional Assorted Quality Measures Feed
Services performed by other qualified therapist in the hospice setting, each 15 minutes.
Medical necessity for this code must be supported by documentation demonstrating that the therapy is a reasonable and necessary component of the patient's palliative care plan, aimed at addressing physical or emotional symptoms associated with their terminal illness.
In simple words: This code covers 15 minutes of therapy provided by a qualified therapist to a terminally ill patient receiving hospice care. This therapy is different from other types of therapy and is given to help the patient feel more comfortable.
This code represents 15 minutes of service provided for a terminally ill patient in a hospice setting by a qualified therapist of a type not described by another code. These services are part of palliative care to help terminally ill individuals live their remaining days with comfort.
Example 1: A terminally ill patient receiving hospice care at home receives 15 minutes of music therapy from a certified music therapist to address anxiety and improve emotional well-being. This service is reported with G9478., A patient in an inpatient hospice facility receives 30 minutes of art therapy from a qualified art therapist as part of their palliative care plan. Since G9478 represents 15-minute increments, this would be reported with two units of G9478., A terminally ill patient receives massage therapy for pain management from a licensed massage therapist in a hospice setting. This service is part of the palliative care plan and helps relieve physical discomfort. Each 15-minute increment of massage therapy would be billed as one unit of G9478.
Documentation should include the type of therapy provided, the therapist's qualifications, the total time spent with the patient, the date of service, and the clinical rationale for the therapy as it relates to the patient's hospice care plan.
- Specialties:Palliative Care, Hospice, and related therapeutic specialties.
- Place of Service:Home, Hospice, Inpatient Hospital, Nursing Facility