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New CMS NCCI Edits | Take Action Today!

ALL PT’ S AND PTA’s IN ANY OUTPATIENT CLINIC PLEASE TAKE ACTION TODAY!

Members please take action regarding CMS Coding announcement that is effective with claims dated January 1, 2020:

“At issue are current procedural terminology (CPT) codes 97530 (therapeutic activities) and 97150 (therapeutic procedures, group, 2 or more individuals) which, until January 1, were allowed to be billed on the same day as physical therapy or occupational therapy evaluation. Under new CMS NCCI edits, however, that’s no longer allowed. And in a further complication, the latest NCCI edits also require use of the 59 modifier-the modifier that’s used to indicate that a code represents a service that is separate and distinct from another service to which it is paired-whenever code 97140 (manual therapy) is billed with an evaluation.”

The American Physical Therapy Association (APTA) did not receive advanced notice of the change which means it is imperative to take action quickly. What you can do: APTA has developed a comment letter template that you can fill in with your personal information and email to Capitol Bridge, LLC, at NCCIPTPMUE@cms.hhs.gov. Make your voice heard!

Download Template

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CPT Code Updates
CMS Coding Reversal Will Apply to Claims Made Beginning January 1, 2020

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