APTA is urging that UnitedHealthcare (UHC) stop its plan to implement Medicare outpatient therapy functional reporting code requirements in its Medicare Advantage plans.
UHC announced its decision to implement functional limitation reporting in their May bulletin (.pdf, p.46). The company plans to require G-codes and severity/complexity modifiers on contracted physical therapist (PT) 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.
In its letter to UHC, APTA argues that the difficulties experienced by PTs during Medicare's changeover to the requirements, as well as limitations in data, make UHC's planned August 1 move ill-advised.
APTA has its own functional limitation reporting webpage that provides resources to help members meet this reporting requirement.
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