GG0130 and GG0170 are the functional assessment items in OASIS-E2 that measure how your patient actually performs self-care and mobility activities. They directly determine the functional impairment level used in PDGM payment grouping — score them wrong and your agency leaves money on the table or risks audit flags.
What Are the GG Items?
Section GG (Functional Abilities and Goals) is a standardized functional assessment that CMS uses across all post-acute care settings — home health, SNFs, IRFs, and LTCHs. CMS introduced these items to create a uniform functional measurement language so patient outcomes could be compared across settings, and so payment could be tied to actual patient function rather than therapy visit counts.
In home health, Section GG replaced the older M-item functional questions (M1800-M1860) as the primary driver of functional impairment scoring under PDGM. The GG items are more granular than the M-items — instead of asking broadly "how does the patient dress?", they break self-care and mobility into specific, observable activities and use a consistent 6-point scale.
There are two GG item groups on the OASIS:
- GG0130: Self-Care — 7 items covering eating, hygiene, dressing, and footwear
- GG0170: Mobility — 18 items covering bed mobility, transfers, walking, stairs, and wheelchair use
Each item is scored at SOC/ROC (admission performance) and at Discharge (discharge performance). The difference between those scores drives the Discharge Function Score quality measure.
The 6-Point Scoring Scale
Every GG0130 and GG0170 item uses the same performance scale. The key distinction between levels is how much of the effort the helper provides — not whether the patient "needs help" in some general sense.
| Code | Level | Definition |
|---|---|---|
| 06 | Independent | Patient completes the activity by themselves with no assistance from a helper. |
| 05 | Setup or clean-up assistance | Helper sets up or cleans up; patient completes the activity independently. No helper assistance during the activity. |
| 04 | Supervision or touching assistance | Helper provides verbal cues, touching/steadying, or contact guard assistance as the patient completes the activity. |
| 03 | Partial/moderate assistance | Helper does less than half the effort. Helper may lift, hold, or support trunk or limbs, but the patient still does most of the work. |
| 02 | Substantial/maximal assistance | Helper does more than half the effort. Helper lifts or holds trunk or limbs and does the majority of the work. |
| 01 | Dependent | Helper does all of the effort. Patient does none, or two or more helpers are required to complete the activity. |
Activity Not Attempted Codes
These codes are used when you were unable to assess the patient performing the activity:
| Code | Meaning |
|---|---|
| 07 | Patient refused |
| 09 | Not applicable — patient did not perform this activity prior to the current illness, exacerbation, or injury |
| 10 | Not attempted due to environmental limitations (equipment not available, space constraints) |
| 88 | Not attempted due to medical condition or safety concerns |
A critical point: overusing the "not attempted" codes hurts your agency. They cannot be used to calculate the Discharge Function Score quality measure, and they provide no data for PDGM functional grouping. If a patient can attempt an activity safely, assess it — even if performance is low.
GG0130: Self-Care Items
GG0130 contains 7 items. For each one, you are scoring the patient's usual performance — what they actually do, not what they could do with maximal cueing and encouragement.
| Item Code | Activity | What You're Assessing |
|---|---|---|
| GG0130A | Eating | Using suitable utensils to bring food and/or liquid to the mouth and swallow. Does not include cooking, cutting meat, or opening containers. |
| GG0130B | Oral hygiene | Using suitable items to clean teeth, including brushing, flossing, and rinsing. Includes cleaning dentures. |
| GG0130C | Toileting hygiene | Maintaining perineal hygiene, adjusting clothes before and after voiding or having a bowel movement. Includes incontinence care if applicable. |
| GG0130E | Shower/bathe self | Washing, rinsing, and drying the body from the neck down (excluding the back). Does not include getting in/out of the shower. |
| GG0130F | Upper body dressing | Putting on and removing shirt or pajama top. Includes managing closures (buttons, zippers, snaps). |
| GG0130G | Lower body dressing | Putting on and removing underwear, pants, socks, shoes (not fastening shoes — that's GG0130H). Includes managing closures. |
| GG0130H | Putting on/taking off footwear | Putting on and removing footwear (socks, shoes, orthotic devices). Includes fastening and unfastening. |
Scoring Tips for Self-Care
Eating (GG0130A): If a caregiver cuts the patient's meat and opens containers before the meal but the patient feeds themselves independently after that, code 05 (Setup). The setup happened before the activity, not during it.
Toileting hygiene (GG0130C): When the patient needs different levels of help for voiding vs. bowel movements, code based on the type and amount of assistance required to complete the entire activity. Use the level that represents the greater assistance needed.
Shower/bathe (GG0130E): This does not include the transfer into the tub or shower — that's a mobility item. If the patient can wash independently once seated on a shower chair but needs help getting to the chair, score the bathing item based on the washing only.
Dressing (GG0130F/G): Upper and lower body are scored separately. A patient who can put on a pullover shirt independently (06) but needs someone to pull up their pants (02) gets two different scores. Don't average them.
GG0170: Mobility Items
GG0170 contains 18 items covering bed mobility, transfers, ambulation, stairs, and wheelchair mobility.
| Item Code | Activity | What You're Assessing |
|---|---|---|
| GG0170A | Roll left and right | Rolling from lying on back to left and right side, and back again. |
| GG0170B | Sit to lying | Moving from sitting on side of bed to lying flat on the bed. |
| GG0170C | Lying to sitting on side of bed | Moving from lying on the back to sitting on the side of the bed with feet flat on the floor, and with no back support. |
| GG0170D | Sit to stand | Coming to a standing position from sitting in a chair, wheelchair, or on the side of the bed. |
| GG0170E | Chair/bed-to-chair transfer | Transferring to and from a bed to a chair (or wheelchair). |
| GG0170F | Toilet transfer | Getting on and off a toilet or commode. |
| GG0170G | Car transfer | Transferring in and out of a car or van on the passenger side. Does not include the wheelchair-to-car component. |
| GG0170I | Walk 10 feet | Once standing, walking at least 10 feet in a room, corridor, or similar space. |
| GG0170J | Walk 50 feet with two turns | Once standing, walking 50 feet and making two turns. |
| GG0170K | Walk 150 feet | Once standing, walking at least 150 feet in a corridor or similar space. |
| GG0170L | Walking 10 feet on uneven surfaces | Walking 10 feet on uneven or sloping surfaces such as grass, gravel, or a ramp. |
| GG0170M | 1 step (curb) | Going up and down a curb or up and down one step. |
| GG0170N | 4 steps | Going up and down four steps with or without a rail. |
| GG0170O | 12 steps | Going up and down 12 steps with or without a rail. |
| GG0170P | Picking up object | Bending/stooping from a standing position to pick up a small object, such as a spoon, from the floor. |
| GG0170Q | Does patient use wheelchair/scooter? | Yes/No screening item — determines whether GG0170R and GG0170S are assessed. |
| GG0170R | Wheel 50 feet with two turns | Once seated in wheelchair/scooter, wheeling at least 50 feet and making two turns. |
| GG0170S | Wheel 150 feet | Once seated in wheelchair/scooter, wheeling at least 150 feet in a corridor or similar space. |
Scoring Tips for Mobility
Walking items (GG0170I/J/K): You assess walking ability even if the patient primarily uses a wheelchair. If the patient can walk 10 feet with a helper, code the walking item based on the assistance required — don't skip it just because the wheelchair is their primary mode.
Stairs (GG0170M/N/O): The patient can take rest breaks between ascending and descending. The activity does not need to happen in one continuous effort. Going up and coming back down counts as one assessment — use the higher level of assistance needed between the two directions.
Car transfer (GG0170G): This is one of the most commonly skipped items. If the patient has not done a car transfer during your visit, use your clinical judgment based on observation of similar transfer activities and patient/caregiver interview. Don't default to a "not attempted" code if you can reasonably estimate performance.
Wheelchair items (GG0170R/S): Only code these if GG0170Q is "Yes." If the patient uses a wheelchair for some distances but walks for others, answer GG0170Q as "Yes" and code both the walking and wheeling items.
How GG Items Affect PDGM Payment
Under PDGM, every 30-day payment period is assigned to one of 432 case-mix groups based on five variables:
- Admission source — community or institutional
- Timing — early (first 30-day period) or late (subsequent periods)
- Clinical grouping — 12 categories based on primary diagnosis
- Functional impairment level — low, medium, or high
- Comorbidity adjustment — none, low, or high
The functional impairment level is determined by responses to the GG0130 and GG0170 items (along with legacy M-items M1800-M1860 which are still collected). The difference between a "low" and "high" functional impairment classification can shift a 30-day payment by $300 to $500 or more depending on the clinical group and other factors.
This is why accurate scoring matters financially. If a clinician codes a patient as more independent than they actually are — even by one level on a few items — the aggregate score may push the functional impairment level from "high" to "medium," and the agency absorbs the payment difference for the entire 60-day episode.
Common Scoring Mistakes
Scoring what the patient can do vs. what they actually do. GG items measure usual performance. If a patient can dress independently when motivated but usually waits for their spouse to help with buttons, code the level of assistance the spouse provides. "Can do" is not the same as "does do."
Confusing setup (05) with supervision (04). Setup means the helper is done before the activity starts — they lay out clothes, open containers, position the shower chair. Supervision means the helper is present and actively cueing or steadying during the activity. If the caregiver stands by and says "reach for the grab bar" while the patient transfers, that's supervision (04), not setup (05).
Averaging across sub-tasks. If a patient needs substantial help with lower body dressing but is independent with upper body dressing, do not split the difference. Each item gets its own score. GG0130F and GG0130G are separate items for this reason.
Defaulting to "not attempted" codes. When a car transfer or stair climb didn't happen during the visit, some clinicians code 88 or 10 by default. CMS guidance is clear: use direct observation when possible, but patient/caregiver report, clinical judgment, and observation of similar activities are all valid assessment methods. Reserve the "not attempted" codes for situations where the activity genuinely cannot be assessed.
Overcoding helper involvement. Two helpers during a transfer automatically triggers code 01 (Dependent), regardless of how much each helper is doing. If one helper could manage the transfer but two were present "just in case," and one of them was actively assisting, code based on the assistance that one helper provided. But if both helpers were needed, it's a 01.
Frequently Asked Questions
Do GG items replace the M-items (M1800-M1860)?
Not entirely. Both are still collected on the OASIS-E2. The M-items continue to be used for some quality measures and outcome calculations. However, the GG items are now the primary driver of the functional impairment level used in PDGM payment grouping. Over time, CMS has signaled that Section GG will fully replace the M-items.
What if the patient's performance varies day to day?
Code the patient's usual performance — the level that represents what they do on most days. If they have a particularly good or bad day during your assessment, use clinical judgment and patient/caregiver interview to determine what is typical. Document the variability in your clinical notes.
Can I use assistive devices during the assessment?
Yes. If the patient uses an assistive device (walker, grab bar, reacher, long-handled sponge) and completes the activity without helper assistance, code 06 (Independent). Assistive devices do not count as helper assistance. A patient who walks 50 feet independently with a rolling walker is a 06, not a 05.
How do I score a patient who was independent before a recent hospitalization but is now impaired?
Score their current performance at the time of assessment. The SOC/ROC performance score captures where they are now. The discharge score will capture where they are at the end of the episode. The difference is what drives the Discharge Function Score quality measure — so an accurate admission baseline is essential for showing improvement.
What's the difference between GG items in home health vs. SNF or IRF settings?
The items and scoring scale are identical across post-acute care settings. CMS designed Section GG to be a uniform functional measurement tool. The difference is context: in home health, you're assessing performance in the patient's own home environment, which may be very different from what they demonstrated in a hospital or rehab facility.
Sources
- CMS OASIS-E Guidance Manual, Section GG: Functional Abilities and Goals (CMS OASIS Data Sets)
- CMS Overview of the Patient-Driven Groupings Model (CMS PDGM Overview)
- CMS Understanding OASIS Function M and GG Item Coding Fact Sheet (CMS Fact Sheet)
- CMS OASIS Quarterly Q&As, Q2 Guidance on GG Items (CMS OASIS Q&As)
- CMS Home Health Change Table for OASIS-E2 (OASIS-E2 Change Table)
Info
This article is part of our OASIS-E2 series. See also: the OASIS-E2 Cheat Sheet (full overview), A1255 Transportation Scoring, and Intercepted Falls Documentation.
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