2025 HCPCS code GN
(Active) Effective Date: N/A Revision Date: N/A Services delivered under an outpatient speech language pathology plan of care - Modifiers for HCPCS codes Feed
Modifier GN is used to indicate that a service is part of an outpatient speech language pathology plan of care.
Yes, modifier GN is itself a modifier applied to applicable procedure codes for outpatient speech and language pathology services.
Medical necessity for services billed with modifier GN is established through the documented plan of care for the diagnosed speech disorder. The plan should outline the patient's specific needs and the rationale for the prescribed speech therapy interventions.
The provider is responsible for delivering the speech and language pathology services in an outpatient setting as part of a plan of care. They must also ensure appropriate documentation, including a diagnosis code for a speech disorder.
In simple words: Modifier GN is used for speech therapy services provided outside of a hospital as part of a treatment plan.
Modifier GN denotes services that are part of an outpatient speech and language pathology plan of care. The provider carries out the service in an outpatient setting. The medical documentation must include a diagnosis code that indicates the patient is suffering from a speech disorder.
Example 1: A patient with aphasia following a stroke receives speech therapy sessions in an outpatient clinic. The sessions are part of a documented plan of care, and the aphasia diagnosis is clearly recorded. Modifier GN is appended to the relevant procedure codes for these therapy services., A child with a diagnosed articulation disorder attends regular speech therapy sessions at an outpatient facility as part of an established plan of care. Modifier GN is appended to the appropriate codes., A patient with dysphagia receives outpatient speech therapy services focusing on swallowing exercises and techniques, following a documented plan of care and with a confirmed dysphagia diagnosis. Modifier GN is applied to the procedure codes for the therapy sessions.
Documentation must include a diagnosis code that indicates a speech disorder, a plan of care for speech and language pathology, and details of the specific services provided.
- Specialties:Speech-Language Pathology
- Place of Service:Office, Outpatient Hospital, Independent Clinic