Reimbursement policy update: Frequency Editing - professional

Beginning with dates of service on or after April 1, 2021, we have updated our policy to reflect that constant attendance, timed modalities for physical therapy, occupational therapy or speech therapy are limited to four (4) units or one (1) hour per date of service for the same member, by the same provider, per therapy type for codes 97110 – 97124, 97129, 97130, 97140, 97533 – 97542 and 97760 – 97763.

 

Additionally, the policy was updated to remove deleted codes 99363, 99364 and J9031 and add the following codes effective January 1, 2020: 96158, 96164, 92273, 92274, 93792, 93973 and J9030.

 

For more information about this policy, visit the Reimbursement Policies page at anthem.com.  

 

928-0121-PN-NE