Physical therapists working in post-acute care settings must be well-versed in Section GG, a standardized assessment tool implemented by the Centers for Medicare and Medicaid Services (CMS). Section GG evaluates a patient’s self-care and mobility abilities at admission and discharge, providing critical data that directly influences reimbursement rates, quality metrics, and functional outcomes.
For physical therapy professionals and practice owners, understanding and efficiently utilizing physical therapy GG codes (PT GG codes) can optimize documentation, ensure accurate billing, and improve patient care. However, the complexity of coding and compliance can be overwhelming without proper guidance.
In this article, we’ll break down what GG codes are in physical therapy, how to use them effectively, and how to streamline the process in your PT practice.
GG codes are part of the Section GG functional assessment used in skilled nursing facilities (SNF), inpatient rehab facilities (IRF), long-term care hospitals (LTCH), and home health agencies (HH). These codes assess a patient’s ability to perform self-care and mobility tasks and measure their progress throughout their rehabilitation journey.
Before Section GG, various post-acute care settings used different functional assessment tools, making it difficult to track patient progress consistently across facilities. Section GG was introduced to standardize this process, ensuring consistent, comparable data across all settings.
The IMPACT Act of 2014 mandated the development of these standardized outcome measures. Now, Section GG is used to determine reimbursement levels under payment models like:
This means that accurate GG coding is essential for PT reimbursement and quality reporting.
Section GG utilizes a 1-6 point scale to assess a patient’s level of independence. Scores should be based on the patient’s usual performance, meaning how they complete tasks more than 50% of the time.
Additionally, if the patient does not attempt the activity, clinicians must select the appropriate reason:
Key Tip: Avoid overusing activity not attempted codes, as some settings automatically default them to a lower functional score, negatively affecting quality ratings and reimbursement.
Whenever possible, observe the patient performing the task before providing verbal or physical assistance. CMS allows scoring based on subjective patient or caregiver interviews, but direct observation ensures higher accuracy.
Since Section GG is an interdisciplinary assessment, it’s essential for physical therapists, occupational therapists, and nursing staff to collaborate and align their documentation.
If a patient is over-scored at admission, their progress may appear minimal, reducing reimbursement potential. Conversely, if a patient is under-scored at discharge, the facility may appear to provide ineffective therapy, impacting quality scores and future referrals.
CMS requires GG data collection during the first 3-5 days of admission and again at discharge. Missing these timeframes can delay reimbursement and create compliance issues.
All physical therapists should undergo CMS training to ensure accurate PT GG codes documentation. Incorrect scoring can lead to audit risks, financial penalties, and misaligned care plans.
Using a robust physical therapy software like PtEverywhere can significantly simplify Section GG coding and compliance. Here’s how:
By integrating PtEverywhere, physical therapy professionals can simplify GG coding, improve efficiency, and optimize financial outcomes without adding administrative burden.
Section GG is a critical component of functional assessment in post-acute care, directly influencing reimbursement and quality metrics. Understanding what GG codes are in physical therapy and using them correctly ensures that patients receive appropriate care, facilities receive proper reimbursement, and PTs maintain compliance with CMS regulations.
By prioritizing observation-based scoring, interdisciplinary collaboration, and compliance with CMS guidelines, PT professionals can maximize efficiency, improve patient outcomes, and enhance revenue.
Start making Section GG assessments easier, faster, and more effective with the right tools today!