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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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  • Home
  • Medicare
  • Medicare Outpatient Physical and Occupational Therapy

Outpatient Physical and Occupational Therapy

Medical Necessity - Criteria for Services

    • Skilled Therapy
    • Rehabilitative Therapy
    • Maintenance Programs

    Assistants, Aides, and Students

      • Supervision of PTAs
      • Supervision of OTAs
      • Students
      • Aides
      • Co-Signatures

      PTA/OTA Modifiers

        • CO/CQ Modifiers
        • Proposed 2022 Rule
        • Who must use the new modifiers
        • Determining when to use the modifiers 
        • How to use the modifiers with timed codes
        • How to use the modifiers with untimed codes
        • Treatment Notes


      CMS 8-Minute Rule and Examples

      KX Modifier

      • 2021 Limits
      • When to use

      Targeted Medical Review Process

      Multiple Procedure Payment Reduction (MPPR)

      PT and OT Codes Covered by Medicare

        • PT Evaluations
        • OT Evaluations
        • Therapeutic Procedures
        • Modalities
        • Orthotics/Prosthetics
        • Muscle and Physical Performance Testing
        • ADL and Work Conditioning
        • Wound Care
        • Fabrication/Application of Casts, Splints and Strapping
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