We are re-evaluating the requirement for the submission of modifiers GN, GO, and GP on claims for services identified by the Centers for Medicare & Medicaid (CMS) as ‘always therapy services’. Effective immediately, we are pausing our requirement for the submission of these modifiers for Anthem Maine members on claims for providers who render therapy services. However, if you are currently submitting GN, GO, and GP modifiers, we recommend you continue to do so as they help identify the specific type of therapy services provided to the member.  

 

In addition, we are aware that some health care providers may currently have claims for Anthem Maine members for these always therapy services that have been denied due to the absence of GN, GO, and GP modifiers. To help resolve these denials, we will identify all such impacted claims and reprocess them without the modifier requirement. Providers who have claim denials due to the absence of these modifiers do not need to contact Anthem to request reprocessing of these claims.  

 

As a reminder, the AIM Rehab Program applies to outpatient physical, occupational, and speech therapy services provided to certain Anthem members. Please verify member benefits by calling the number on the member’s ID card. Prior authorization can be done in one of the following ways:

  • Access AIM’s ProviderPortalSM directly at www.providerportal.com. Online access is available 24/7 to process orders in real-time, and is the fastest and most convenient way to request authorization.
  • Access AIM via the Availity Web Portal at www.availity.com.
  • Call AIM’s Contact Center toll-free number at 866-714-1107, Monday - Friday, 8 a.m. - 5 p.m.

 

If you have any questions, please call the Maine Healthcare Providers Dedicated Line at 833-690-2936, Monday - Friday, 8:30 a.m. - 5 p.m.

 

Thank you for the services you provide to our members.  

 

1220-0222-EM-ME



Featured In:
GN, GO, GP therapy modifier requirement paused for Anthem Maine members