Billing Operations
Does Medicare Pay Differently When a PTA Furnishes Therapy?
For applicable Medicare Part B outpatient physical therapy services, a service furnished in whole or in part by a PTA may require the CQ modifier when the PTA’s independent portion exceeds the de minimis threshold. For claims subject to the reduction, Medicare pays 85% of the otherwise applicable amount. Verify the current CMS rule and claim circumstances before billing.
- Medicare PT billing
- PTA modifier
- Reimbursement
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