Like the ’90s hip-hop-themed title of this blog post implies, Functional Limitation Reporting G-codes may be new, but they’re nothing to fret over. Essentially, effective July 1, 2013, CMS began requiring therapists to report new G-codes in an effort to further emphasize function and functional progress in therapy treatment. But the good news is that you should already be assessing—and documenting—functional progress as part of your short- and long-term goal setting at the initial evaluation, tenth visit (at least), and discharge. Now, all you need to do is assign a G-code that reflects that progress.

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What’s a G-Code?

CMS uses G-codes to collect information about its beneficiaries’ functional limitations via claim forms. As we wrote here, “CMS will use all of this information to better understand the beneficiary population that uses therapy services and how their functional limitations change as a result of the therapy they complete. Furthermore, CMS will use the data they collect to reform future payment structures.”

There are 42 codes.

There are 42 G-codes available to choose from to best describe your patient’s primary functional limitation (i.e., the main reason that patient sought out therapy services). Here are just a few:

Mobility: Walking and Moving Around
  • G8978 Mobility: walking and moving around functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8979 Mobility: walking and moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8980 Mobility: walking and moving around functional limitation, discharge status, at discharge from therapy or to end reporting
Changing and Maintaining Body Position
  • G8981 Changing and maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8982 Changing and maintaining body position functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8983 Changing and maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting
Self Care
  • G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8989 Self care functional limitation, discharge status, at discharge from therapy or to end reporting
Other PT/OT Primary Functional Limitation
  • G8990 Other physical or occupational primary functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8991 Other physical or occupational primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8992  Other physical or occupational primary functional limitation, discharge status, at discharge from therapy or to end reporting
Other PT/OT Subsequent Functional Limitation
  • G8993 Other physical or occupation subsequent functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8994 Other physical or occupational subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8995 Other physical or occupational subsequent functional limitation, discharge status, at discharge from therapy or to end reporting
Swallowing
  • G8996 Swallowing functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8997 Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8998 Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting

Other categories include motor speech, spoken language comprehension and expression, attention, memory, voice, and other SLP functional limitation. If your patient’s functional limitation does not fit into one of the predefined categories, then you can use the “other” category. For a full list of the FLR G-codes, check out this blog post.

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How do I use the codes?

The Modifiers

After selecting the appropriate G-code, PTs, OTs, and SLPs also need to choose one severity modifier (on a seven-point scale) to convey the severity of that patient’s functional limitation. You’ll make this selection based on the score of an outcome measurement tool as well as your skilled clinical knowledge as a therapist. You’ll also use these modifiers to indicate your projected goal—where you expect your patient to be in terms of his or her functional status by the end of therapy. If you do not expect your patient to improve—as a result of a degenerative disease, for example—or expect limited improvement, then you can use the same modifier for the current status and projected goal status.

Functional Limitation Severity Modifier Codes

Modifier Impairment Limitation Restriction
CH 0% impaired, limited, or restricted
CI At least 1% but less than 20% impaired, limited, or restricted
CJ At least 20% but less than 40% impaired, limited, or restricted
CK At least 40% but less than 60% impaired, limited, or restricted
CL At least 60% but less than 80% impaired, limited, or restricted
CM At least 80% but less than 100% impaired, limited, or restricted
CN 100% impaired, limited, or restricted

You’ll also want to include the appropriate therapy modifier—GO, GP, or GN—to indicate that the services you provided were furnished under an OT, PT, or SLP therapy plan of care, respectively.

Functional Limitation Therapy Modifier Codes

Therapy modifiers indicate the type of therapy service you’re providing.

Modifier Services Delivered Under Outpatient POC
GO Occupational Therapy
GP Physical Therapy
GN Speech-Language Pathology
The Claim Form

To be clear, all PTs, OTs, and SLPs must report two non-payable G-codes—as well as all appropriate modifiers—on their claim forms for all Part B Medicare beneficiaries:

  • at the patient’s initial evaluation (current status and goal status);
  • at a minimum every tenth visit (current status and goal status); and
  • at discharge (discharge status and goal status).
The Effective Date.

As stated above, CMS began requiring therapists to report G-codes on July 1, 2013. And you’ll find everything you need to remain compliant with this requirement within WebPT.


For even more information about functional limitation reporting, check out FunctionalLimitation.org. There, you can watch a comprehensive FLR webinar and take a quiz to test your FLR prowess. Still have questions? Head on over to this page for frequently asked FLR questions as well as their answers.

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