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...

News

2025 APTA House of Delegates Motions Posted

Jun 3, 2025

APTA members can now access 48 motions that include seven proposed bylaws amendments that will be forwarded for consideration by the 2025 APTA House of

Perspective

Cancer Rehabilitation Month Champions Healing Beyond Treatment

Jun 2, 2025

Members of APTA Oncology share information and resources about Cancer Rehabilitation Month, a new public awareness campaign.

Feature

Short-Handed: Workforce Projections Predict Profession Shortages

Jun 1, 2025

A new APTA report outlines forecasts of a supply shortage of physical therapists through 2037.