Professional reimbursement policy update: Frequency Editing

In  our January 1, 2021, provider notice, we shared information regarding changes to the Frequency Editing professional reimbursement policy. The notice indicated that constant attendance, timed modalities for physical therapy, occupational therapy or speech therapy are limited to 4 Units or 1 hour per date of service for the same member, by the same provider, per therapy type for (97110 – 97124, 97129, 97130, 97140, 97533 – 97542, 97760 – 97763).  Upon further review, we have reconsidered our position and have removed this edit for dates of service on or after April 1, 2021. 

1126-0521-PN-CA