G0042 HCPCS Level II code: Referral to physical, occupational, speech, or recreational therapy
G0042 is the HCPCS code for “Referral to physical, occupational, speech, or recreational therapy” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G0042Referral to physical, occupational, speech, or recreational therapy
Short description: Ref to therapy
HCPCS · United States
Medicare details
The indicators CMS publishes with G0042 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Undefined codes
- Added
- Jan 1, 2022
Where G0042 sits
- 1G codesProcedures and professional services
- 2Active code G0042Referral to physical, occupational, speech, or recreational therapy
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code G0042 mean?
G0042 is the HCPCS code for “Referral to physical, occupational, speech, or recreational therapy” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G0042?
CMS lists G0042’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside G0042
All G codesG0036Patient or care partner decline assessmentG0037On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed…G0038Clinician determines patient does not require referralG0039Patient not referred, reason not otherwise specifiedG0040Patient already receiving physical/occupational/speech/recreational therapy during the measurement periodG0041Patient and/or care partner decline referralG0043Patients with mechanical prosthetic heart valveG0044Patients with moderate or severe mitral stenosisG0045Clinical follow-up and mrs score assessed at 90 days following endovascular stroke interventionG0046Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke interventionG0047Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessedG0048Patients who receive palliative care services any time during the intake period through the end of the measurement year