Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - Professional
In the contract amendment dated October 1, 2021, Anthem Blue Cross and Blue Shield in Virginia and our affiliate HealthKeepers, Inc. included updates to the following Commercial reimbursement policies:
- Modifier Rules – Professional
- Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation – Professional
For clarification, these modifier updates align with the codes the Centers for Medicare & Medicaid Services (CMS) has designated as “always therapy” services, and require GN, GO or GP modifiers for physical therapy, occupational therapy, or speech-language pathology services when billed on a professional claim.
November 2021 Anthem Provider News - Virginia