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Which modifiers have to appended to all therapy claims?
GP: Physical therapy services.
GO: Occupational therapy services.
GN: Speech therapy services.
When does the KX modifier need to be added to the claim?
In 2022 the KX modifier threshold is $2,150 for PT and SLP services combined. And $2,150 for OT services.
This applies the all therapy services during the year, not just the services provided by the billing therapist.
By appending the KX modifier, the provider is attesting that the services billed:
When do the CO/CQ modifiers need to be added to claims?
CQ modifier: Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant
CO modifier: Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant
Medicare required that claims for services furnished in whole or in part by a PTA or an OTA must include the CQ or CO modifier, respectively, when:
Medicare Therapy Services available at https://www.cms.gov/medicare/billing/therapyservices
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