Wiki Medicare PT 97002

[tdml97@yahoo.com]

I am having a problem w/ Medicare paying for this. Is there any reference material on this code only? Specific payable diagnosis? Modifiers needed or not? Time frame on when it can be done?

I appreciate any help I can get with this.

Thanks in advance.

Christina H.



Just needed to add mod 59 to it & got paid.

 

[cmcgarry]

Are you billing it along with PT modalities the same day? If so, they are hitting the CCI edits. Also, check the Medicare Internet Only Manual; they have a lot of rules for PT.

 

[ms_rnell]

Use GP modifier on PT billing for medicare.

 

[Cyndi113]

You always need to add modifier 59 if you are billing for any treatment in addition to the 97002. This code is usually paid every 30 days (re-certification).

 

[armandorj]

question on 97002

Recently the topic has surfaced that 97002 should only be used when you are doing an actually re-evaluation...but other people say you can use it with Medicare and other insurance when you are doing a PR (progress note) and a recertification.
Does anyone know where I can find clarity on this issue.
Thanks