UnitedHealthcare announced in its May bulletin that the Medicare outpatient therapy functional reporting requirement would apply to UnitedHealthcare Medicare Advantage plans beginning August 1 (the announcement can be found on page 46 of the bulletin).
G-codes and severity/complexity modifiers will be required on contracted physical therapist claims with dates of service on or after August 1, 2014. Claims that do not include the appropriate G-code and modifiers will be rejected.
APTA offers a functional limitation reporting webpage that provides resources to help members meet this reporting requirement.
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