January 1, 2020 PT/OT Modifiers Raising Questions

As billing is underway for January services, we thought we’d recirculate the Assistant Modifier Requirements that went into effect for dates of service 1/1/2020.


Attached, please find CMS’ transmittal addressing the new modifier identifying PT (CQ) and

OT (CO) services provided in whole or in part by a therapy assistant.

Jan 2020 Modifiers for Assistants
.pdf
Download PDF • 170KB

Timelines

  • 1/1/2019: Modifiers must be created

  • 1/1/2020: Modifiers must be on claims for dates of service on and after January 1, 2020

  • 1/1/2022:Must be tied to reduced payment rates at 85% of the physician fee schedule effective in calendar year 2022.


Let's Get to the Point:

Casamba and Optima have added these modifiers to their documents which should be coming through on exports to upload. Please let us know if you have any additional questions/ concerns.