Skip to main content

In passing the Bipartisan Budget Act of 2018, Congress required that by January 1, 2019, the Centers for Medicare and Medicaid Services establish a modifier to indicate when an outpatient physical therapy service is furnished in whole or in part by a physical therapist assistant.

Starting January 1, 2022, outpatient physical therapy services covered under the Medicare physician fee schedule that are furnished at least in part by a PTA will be paid at 85% of the applicable fee schedule rate. (A similar modifier was designated for services provided by an occupational therapy assistant, which also will be subject to the 85% payment differential).

So that providers are prepared for 2022, use of the modifier was mandated as of January 1, 2020, for outpatient therapy providers across almost all settings — including private practices, skilled nursing facilities, home health agencies, outpatient hospitals, rehabilitation agencies, and comprehensive outpatient rehabilitation facilities. The modifier is CQ for PTAs (CO for OTAs).

Log in or create a free account to keep reading.


Join APTA to get unlimited access to content.


You Might Also Like...

Article

Matthews Urges Resilience and Reframing During 2025 Woodruff Lecture

Aug 12, 2025

Didi Matthews, PT, DPT, delivered the sixth annual Lynda D. Woodruff Lecture in June. Her speech, titled "Reframing DEI: Clarity, Courage, and Commitment

Open Access

500 Member Advocates Push for Change During APTA Capitol Hill Day

Aug 12, 2025

Meaningful reforms to the Medicare Physician Fee Schedule, expanding access to PT falls screening and prevention, increasing access to pelvic health physical

News

APTA State Chapters Fuel Legislative Wins in 2025

Aug 6, 2025

As the 2025 legislative season has come to a close in most states, many APTA chapters achieved significant victories that improve payment, address provider