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To properly bill for PTA-provided services, the supervising PT must be on site—because PTAs cannot bill for their own services. Instead, the supervising PT must bill using his or her own credentials.
- Physical Therapy Billing
With our guide to billing, physical therapists and other...
- Physical Therapy Billing
With our guide to billing, physical therapists and other rehab professionals can get best practices on coding, modifiers, and more.
Every service performed by a physical therapist (PT), occupational therapist (OT), or speech-language pathologist (SLP) requires a therapy modifier (GP, GO, GN) for claim submission. So in this scenario, you would affix the GP modifier to the claim.
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.
Note: Check with all your non-Medicare fee-for-service payers to see if they require the PTA modifier. How To Use This Guide . Use this guide to help you identify when you must apply the CQ modifier. Also refer to . CMS guidance and billing examples. (Note: APTA is working with CMS to revise its guidance and examples for when the
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.
In November 2021, CMS released its final 2022 Physician Fee Schedule (PFS), which specified updates to several therapy sectors. First, CMS confirmed a 1% reduction of Medicare Part B physical therapy and occupational therapy rates.
