# physical therapy modifiers for Medicare



## woowooz7 (Dec 8, 2014)

Medicare is stating all therapy codes need a modifier. Do you know if that is payor specific or are they wanting the specific body part as the modifier?

Thanks in advance.  I know NOTHING about physical therapy coding.


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## mhstrauss (Dec 9, 2014)

woowooz7 said:


> Medicare is stating all therapy codes need a modifier. Do you know if that is payor specific or are they wanting the specific body part as the modifier?
> 
> Thanks in advance.  I know NOTHING about physical therapy coding.



Typically, the main modifiers I see used with Physical Therapy are GP, KX, 59.  But of course, that will all depend on documentation.  This is a great place to look regarding Medicare PT billing:

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c05.pdf

HTH!


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## mitchellde (Dec 9, 2014)

They are looking for the functional,status modifiers and codes more than likely and I have found this to be true for all payers.


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## honeybee (Dec 22, 2014)

Medicare requires that we bill modifier GP for PT and mod GO for OT on each line item of the claim. As the other posters stated you are also required to periodically indicate functional reporting on the claim which is  a different series of codes which do start with a "G" and modifiers to indicate the patients status and how they are progressing. http://www.cms.gov/outreach-and-edu...k-mln/mlnmattersarticles/downloads/se1307.pdf 

Missy Lupercio
CPC-A
Spooner Physical Therapy


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