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Thread: modifier GP

  1. #1
    Join Date
    Apr 2007

    Default modifier GP

    Can modalities administrated by a Chiropractor, DC, be billed with the modifier GP
    as I read below, I am not sure…Looking for someone who has experienced this-

    According to the Centers for Medicare and Medicaid Services, a GP modifier means that “Services [are] delivered under an outpatient physical therapy plan of care.” This means that the service or item received was a part of a preexisting plan of care for physical therapy created by Medicare doctors and physical therapists. It also means that the service was performed in an outpatient setting. Put another way, the patient did not need to be admitted to a hospital to obtain the service. In order for physical therapy to be covered by Medicare, a plan of care is required.
    Last edited by p_morales; 01-07-2013 at 03:11 PM.

  2. #2
    Join Date
    Apr 2007


    You can bill with the GP modifier but you should also use a GY modifier becuase Medicare will not pay a DC for anything that not a 98940, 98941 or 98942. This will get Medicare to forward you claim to the secondary with all the correct denials, If the patient has a secondary.

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