PT Coding Question

Billing500

Networker
Messages
42
Best answers
0
Hi!

We're billing the following PT codes:
97163
97014
97010
97140
97535
All are affixed with a GP modifier for Medicare, however is a -59 needed? All of our notes seem to indicate that it's only required if billing CPT 97164 (Re-Eval). Can someone please confirm?
Also, for Medicare, please confirm that the cap is based on ALLOWED AMOUNT and NOT the # of visits. We've been getting conflicting statements, but Medicare shows $1980 as the cap (for PT and SLP).

Also, when billing the following, please confirm NO -59 is required:
97014
97140
97112
97110

Thank you very much!
 

jflynn124

Contributor
Messages
19
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0
Don't forget to bill the functional G-code set with the therapy.


97163-59-GP
97014-GP
97140-59-GP
97112-GP
97110-GP
 
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