Therapy modifiers indicate the discipline of the plan of care.
Occupational therapy modifiers |
Modifier |
Description |
CO |
Outpatient physical therapy services furnished in whole or in part by a occupational therapist assistant. |
GO |
Service delivered personally by an occupational therapist or under an outpatient occupational therapy plan of care. |
When reporting modifier CO, the GO modifier should also be submitted to identify the services furnished under an OT plan of care. Note: The CO modifier is not applicable to claims from critical access hospitals.
Physical therapy modifiers |
Modifier |
Description |
CQ |
Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant. |
GP |
Service delivered personally by a physical therapist or under an outpatient physical therapy plan of care |
When reporting modifier CQ, the GP modifier should also be submitted to identify the services furnished under a PT plan of care. Note: The CQ modifier is not applicable to claims from critical access hospitals.
Speech language pathology modifiers |
Modifier |
Description |
GN |
Service delivered personally by a speech-language pathologist or under an outpatient speech-language pathology plan of care |
KX modifier therapy threshold amount |
Modifier |
Description |
KX |
Requirements specified in the medical policy have been met |
Note: The KX modifier is used to confirm that services are medically necessary as justified by appropriate documentation in the medical record once the threshold amount has been met. There is one threshold amount for PT and SLP services combined and a separate threshold amount for OT services. Medicare will deny your claims for therapy services above these amounts without the KX modifier.
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