Billing PTA services Medicare

midnight1995

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Per Medicare PTAs are not enrolled. Per Medicare allows therapist assists to provide therapy services in an outpatient private practice setting. as long as services are performed under the direct supervision of a licensed therapist. Which is very clear but the question is with the New Modifiers - CQ Outpatient physical therapy services furnished in whole or in part by a PTA and GP services delivered personally by a PT or under an outpatient PT plan of care.

The questions is the claim would be billed as the rendering provider = Physical therapist and the above modifiers indicating that the PTA provided the services. Is anyone billing this way and having any denials for invalid modifier.

Thank you.
 
Last edited:

b.cobuzzi

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Yes it would be billed with the modifier. I do not bill for physical therapy, so I cannot tell you if there have been denials. You may want to ask this question in the Billing/Reimbursement forum or in the Orthopedic forum where you would find those billing PT
 
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