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Use this guide to help you identify when you must apply the CQ modifier. When billing timed treatment codes, first determine the total number of units that can be billed based on the 8-minute rule. Then determine, for each unit, whether the PTA furnished more than 10% of each unit independent of the physical therapist.
If you’re billing for PTA-provided services, then be sure your documentation includes the following: Language stating that you—the licensed PT—reviewed your plan of care with the PTA who’s providing services under your direction and direct supervision.
By applying physical therapy modifiers correctly and knowing rehab therapy billing rules like the back of your hand (or by partnering with someone who remembers them for you), you too can become a clean claims champion.
Learn about the rules and requirements set by Medicare and private insurance for the CQ modifier and billing for services provided by PTAs. Stay compliant and maximize your reimbursement.
CMS has established two modifiers, CQ and CO, to indicate services furnished in whole or in part by a PTA or OTA, respectively. The modifiers are defined as follows:
Therapeutic services include all timed and untimed coded procedures and modalities including initial evaluations and reevaluations. Secondly, codes must be applied for any care provided solely by the PTA or OTA.
7 Απρ 2021 · When billing timed treatment codes, first determine the total number of units you can bill based on the 8 minute rule. Then determine, for each unit, whether the PTA furnished more than 10% of each unit independently of the physical therapist. This is the de minimis standard for determining “in part” services.
