Updated HCPCS Codes for Medicare PPS Billing

Medicare has created four new HCPCS Codes for Medicare PPS Billing effective January 1, 2017.  The old HCPCS Codes G0163 and G0164 will be retired.  New HCPCS Codes have been created to specify RN verses LPN services for Training and Education and Observation and Assessment.

The new HCPCS are:

G0493- Skilled Services of a RN for observation and assessment

G0494- Skilled Services of a LPN for observation and assessment

G0495- Skilled Services of a RN for training and education

G0496- Skilled Services of a LPN for training and education

The new HCPCS codes are available with Main Office software version 6053 and Clinical Software version 2506 both dated 11/28/16.

Agencies may begin using these new HCPCS codes now for Medicare Services.  The software will automatically convert any visits entered into the software with the new HCPCS codes with a Date of Service prior to January 1, 2017 back to G0163 or G0164 when claims are generated.

Agencies who have established and used specific service codes for HCPCS G0163 and G0164 will need to update the service set up to reflect the new HCPCS.  Agencies may update the existing service to reflect the RN service and add additional service codes to reflect the new HCPCS for LPN services.

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